This small study estimated the prevalence of SARS-COV-2 among pediatric cancer patients at Memorial Sloan Kettering Cancer Center in the US.

Between March 10 and April 12, 2020, the center performed a total of 335 tests for SARS-CoV-2 among 178 pediatric patients and 74 of their caregivers. Mean ate was 11.1 years (sd=8.5). Among this sample, 20 (11.2%) had positive test results. In this group, 3 were female, 1 required noncritical care hospitalization for COVID-19 symptoms, and 3 were admitted for concomitant fever and neutropenia, cancer morbidity, or planned chemotherapy.

Of patients specifically tested for positive screening or symptoms (screen positive or symptom positive), the rate of positivity for SARS-CoV-2 was 29.3%.

Of the 74 caregivers tested, 13 (17.6%) of 10 patients tested positive for SARS-CoV-2. Notably among 68 asymptomatic and unexposed caregivers (screen negative and symptom negative), 10 tested positive for SARS-CoV-2 (14.7%).

Simultaneous detection of virus in patient and caregiver was found in 5 patient/caregiver dyads, whereas 5 patients were negative for virus despite close exposure to caregivers with COVID-19.

In summary, these data that (1) the overall morbidity of COVID-19 in pediatric patients with cancer is low with only 5% requiring hospitalization for symptoms of COVID-19; (2) the rate of SARS-CoV-2 infection among asymptomatic pediatric patients is very low; (3) unrecognized SARS-CoV-2 infection in asymptomatic caregivers is a major infection control consideration; and (4) consistent with the sex difference previously seen in adults with critical disease, there is a male bias in SARS-CoV-2 infections in children.