Introduction/Background*During COVID-19 pandemic many studies have been published; concerning oncological patients SARS-CoV2 infection is correlated to a 29.4% mortality rate. Few data describe the incidence and outcome of COVID-19 infection in patients undergoing chemotherapy.

The aim of our study is to assess COVID-19 behavior in patients treated with chemotherapy.

Methodology We considered 179 patients affected by gynecological cancers who underwent chemotherapy during the pandemic. Patients were educated to respect COVID-19 rules of conduct. We used different criteria to screen the patients with the rhino-pharyngeal swab and anamnestic questionnaire, so we analyzed two different periods: 11^th March–15^th October 2020, 16^th October 2020–30^th April 2021. From 11^th March to 30^th April 2020 we screened the symptomatic patients; from 1^st May to 15^th October 2020 the swab was made to all patients before their first access. Conversely, during the second period (16^th October 2020-30^th April 2021), we made the swab to all patients every 28 days. Patients resulted positive to COVID-19 were suspended from chemotherapy until their first negative swab.

Result(s)*During the first period 806 chemotherapy cycles were carried out: there were no positive patients. During the second period 775 chemotherapy cycles were carried out: 13/99 (13.3%) patients resulted positive. Three of them (23.1%) were symptomatic; among these only one patient (7.7%) had SARS-CoV2 pneumonia and was admitted to semi-intensive care; what is important to underline is that this patient was positive before starting the second line chemotherapy. Two patients (15.4%) were paucisymptomatic, one of whom died for cancer progression. Overall, 10 patients (77%) resulted asymptomatic.

Conclusion*Our experience supports that chemotherapy does not worsen SARS-CoV2 symptoms and mortality rate. Only with periodic swabs it was possible to identify positive patients, as they were asymptomatic. Moreover, none of the patients who became positive during chemotherapy developed pneumonia.

Further studies are needed to evaluate the protective role of chemotherapy against COVID-19 symptoms and complications.