Parambil, Badira CheriyalinkalMoulik, Nirmalya RoyDhamne, ChetanDhariwal, NidhiNarula, GauravVora, TusharPrasad, MayaChichra, AkankshaJatia, ShaliniChinnaswamy, GirishBanavali, Shripad2023-08-192023-08-192022-05Parambil Badira Cheriyalinkal, Moulik Nirmalya Roy, Dhamne Chetan, Dhariwal Nidhi, Narula Gaurav, Vora Tushar, Prasad Maya, Chichra Akanksha, Jatia Shalini, Chinnaswamy Girish, Banavali Shripad. COVID-19 in Children with Cancer and Continuation of Cancer-Directed Therapy During the Infection. Indian Journal of Pediatrics. 2022 May; 89(5): 445–4510973-76930019-5456http://imsear.searo.who.int/handle/123456789/223714Objective To report the experience with COVID-19 in children with cancer at the largest tertiary-cancer care and referral center in India. Methods This study is a single tertiary center experience on COVID-19 in children with cancer and continuation of cancerdirected therapy in them. Children?15 y on active cancer treatment detected with COVID-19 until September 15th, 2020 were prospectively followed up in the study. Patients were managed in accordance with well-laid guidelines. Treatment was continued for children with COVID-19 who were clinically stable and on intensive treatment for various childhood cancers. Results One hundred twenty-two children (median age 8 y; range 1–15 y, male:female 1.7:1) with cancer were diagnosed with COVID-19. Of 118 children, 99 (83.9%), 60 (50.8%), 43 (36.4%), 26 (22.0%), and 6 (5.1%) had RT-PCR positivity at 14, 21, 28, 35, and 60 d from diagnosis of COVID-19, respectively. Scheduled risk-directed intravenous chemotherapy was delivered in 70 (90.9%) of 77 children on active systemic treatment with a median delay of 14 d (range 0–48 d) and no increased toxicities. All-cause mortality rate was 7.4% (n=9) and COVID-19 related mortality rate was 4.9% (n=6). One hundred-ffteen (94.2%) children with COVID-19 did not require any form of respiratory support during the course of infection. Conclusions COVID-19 was not a major deterrent for the continuation of active cancer treatment despite persistent RT-PCR positivity. The long-term assessment of treatment adaptations requires further prospective follow-up and real-time addressal.Cancer-directed therapyChildren with cancerCOVID-19MortalityJournal ArticleIndiaDepartment of Pediatric Oncology, Tata Memorial Hospital, Homi Bhabha National Institute (HBNI), Mumbai, Maharashtra 400012, India