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Pediatrics

Incidence of COVID-19 in Pediatric Surgical Patients Among 3 US Children’s Hospitals

Educational Objective
To understand the rate of COVID-19 infection amongst children after pediatric surgery

1 Credit CME

JAMA Surgery

Published Online: June 4, 2020

Research Letter

Article Information and Disclosures

Elaina E. Lin, MD¹;

Todd J. Blumberg, MD²;

Adam C. Adler, MD, MS³;

Faris Z. Fazal, BS⁴;

Divya Talwar, PhD, MPH⁴;

Kyle Ellingsen, BS⁵;

Apurva S. Shah, MD, MBA⁴

Author Affiliations

¹The Children’s Hospital of Philadelphia, Department of Anesthesiology and Critical Care Medicine, Philadelphia, Pennsylvania
²Seattle Children’s Hospital, Department of Orthopedics and Sports Medicine, Seattle, Washington
³Texas Children’s Hospital, Department of Anesthesiology, Perioperative and Pain Medicine, Houston
⁴The Children’s Hospital of Philadelphia, Division of Orthopaedic Surgery, Philadelphia, Pennsylvania
⁵University of Washington School of Medicine, Seattle, Washington

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The coronavirus disease 2019 (COVID-19) pandemic continues to spread, with more than 4.6 million confirmed cases worldwide as of May 19, 2020. Children appear less susceptible, with the Chinese Center for Disease Control and Prevention reporting that children constitute only 2.16% of confirmed cases.¹ This may underestimate the true incidence of COVID-19 in children. Children are more likely to be asymptomatic or mildly symptomatic and thus less likely to be tested. The purpose of this study was to determine the incidence of COVID-19 in pediatric patients presenting for surgery at 3 tertiary care children’s hospitals across the United States.

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Article Information

Corresponding Author: Apurva S. Shah, MD, MBA, Division of Orthopaedic Surgery, 3401 Civic Center Blvd, 2nd Floor Wood Center, Philadelphia, PA 19104 (shaha6@email.chop.edu).

Published Online: June 4, 2020. doi:10.1001/jamasurg.2020.2588

Author Contributions: Drs Lin and Shah had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Lin, Blumberg, Shah.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Lin, Shah.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Talwar.

Administrative, technical, or material support: All authors.

Supervision: Lin, Blumberg, Shah.

Conflict of Interest Disclosures: None reported.

Additional Contributions: We acknowledge Philip D. Bailey, DO; David E. Cohen, MD; and Charles Dean Kurth, MD, for their role in developing a universal screening program for severe acute respiratory syndrome coronavirus 2 in children undergoing surgery at the Children’s Hospital of Philadelphia in Philadelphia, Pennsylvania. No compensation was received for their role in this investigation.

References

Wu Z , McGoogan JM . Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA. Published online February 24, 2020. doi:10.1001/jama.2020.2648 PubMed Google Scholar

Kam KQ , Yung CF , Cui L , et al. A well infant with coronavirus disease 2019 (COVID-19) with high viral load. Clin Infect Dis. Published online February 28, 2020. doi:10.1093/cid/ciaa201 PubMed Google Scholar

Dong Y , Mo X , Hu Y , et al. Epidemiology of COVID-19 among children in China. Pediatrics. Published online March 16, 2020. doi:10.1542/peds.2020-0702 PubMed Google Scholar

Sutton D , Fuchs K , D’Alton M , Goffman D . Universal screening for SARS-CoV-2 in women admitted for delivery. N Engl J Med. Published online April 13, 2020. doi:10.1056/NEJMc2009316 PubMed Google Scholar

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.