The risk of the novel coronavirus disease 2019 (COVID-19) to pediatric oncology patients is unknown. Here, we report eight pediatric oncology patients receiving active cancer therapy that tested positive for COVID-19. Three developed severe cardiorespiratory symptoms (as defined by evidence of heart failure by echocardiogram and/or intubation secondary to respiratory failure), including one death as a result of COVID-19 infection. We identified prior anthracycline exposure and pre-COVID cardiac function as significantly associated with the development of severe cardiorespiratory complications. These data merit future and further investigation of risk factors for severe complications related to COVID-19 infections in pediatric oncology patients.