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Prevalence of SARS-CoV-2 Infection in Children Without Symptoms of Coronavirus Disease 2019

Educational Objective
To understand the prevalence of COVID-19 infection in children without COVID-19 symptoms
1 Credit CME

During the coronavirus disease 2019 (COVID-19) pandemic, determination of prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among children without symptoms of COVID-19 is critical to guide infection control policy. While estimates have been reported in children undergoing emergency surgery1 and oncologic care,2 these small studies have limited generalizability to large populations of children without symptoms. When children's hospitals resumed elective medical and surgical care in April and May 2020, many implemented routine SARS-CoV-2 testing for children presenting for care not associated with suspicion of COVID-19. Here, we report the prevalence of positive SARS-CoV-2 test results in children without symptoms at 28 children's hospitals across the US.

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Article Information

Accepted for Publication: July 14, 2020.

Corresponding Author: Dylan K. Chan, MD, PhD, Division of Pediatric Otolaryngology, Department of Otolaryngology–Head and Neck Surgery, University of California, San Francisco, 2233 Post St, 3rd Floor, Box 1225, San Francisco, CA 94143 (dylan.chan@ucsf.edu).

Published Online: August 25, 2020. doi:10.1001/jamapediatrics.2020.4095

Correction: This article was corrected on October 5, 2020, to correct errors in Figure 1. The labels for 1.0 and 1.5 on the y-axis of the forest plot graph were reversed. Also, the square indicating the prevalence for site 14 was displaced from its true value, 2.21%, to approximately 2.75%; this square was also larger than it should have been. The errors have been corrected.

Author Contributions: Ms Sola and Dr Chan had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: David, Chan.

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

Drafting of the manuscript: Sola, Chan.

Critical revision of the manuscript for important intellectual content: David, Rosbe, Baba, Ramirez-Avila, Chan.

Statistical analysis: Sola, Chan.

Administrative, technical, or material support: David, Baba.

Supervision: Rosbe, Chan.

Conflict of Interest Disclosures: None reported.

Additional Contributions: We would like to acknowledge the following individuals, who contributed SARS-CoV-2 asymptomatic testing data from each of their hospitals as well as helpful feedback on the manuscript: Gurpreet S. Ahuja, MD, Division of Pediatric Otolaryngology–Head and Neck Surgery, Children's Hospital of Orange County; Erica C. Bennett, MD, Division of Otolaryngology, University of New Mexico; Bobby L. Boyanton Jr, MD, Department of Pathology, Arkansas Children's Hospital; Matthew T. Brigger, MD, MPH, Division of Otolaryngology, Rady Children's Hospital; Kenny H. Chan, MD, Department of Otolaryngology, Children's Hospital Colorado; Alan G. Cheng, MD, Department of Otolaryngology–Head and Neck Surgery, Stanford University; David H. Chi, MD, Division of Pediatric Otolaryngology, Children's Hospital of Pittsburgh; Michael Cunningham, MD, Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital; Charles Elmaraghy, MD, Department of Otolaryngology, Nationwide Children's Hospital; Mark E. Gerber, MD, Division of Otolaryngology, Head and Neck Surgery, Phoenix Children's Hospital; Steven L. Goudy, MD, MBA, Division of Pediatric Otolaryngology, Emory School of Medicine; Heather C. Harrington, MD, Division of Otolaryngology, University of Vermont Medical Center; Jeffery A. Koempel, MD, MBA, Division of Otolaryngology–Head and Neck Surgery, Children's Hospital Los Angeles; Jennifer M. Lavin, MD, MS, Division of Pediatric Otolaryngology, Ann & Robert Lurie Children's Hospital of Chicago; Gene Liu, MD, Division of Otolaryngology, Cedars-Sinai Medical Center, Los Angeles; Carol J. MacArthur, MD, Division of Pediatric Otolaryngology, Oregon Health and Science University; Jeremy D. Meier, MD, Division of Pediatric Otolaryngology, University of Utah School of Medicine; Anna H. Messner, MD, Division of Pediatric Otolaryngology, Texas Children's Hospital; Ron B. Mitchell, MD, Division of Pediatric Otolaryngology, UT Southwestern and Children's Medical Center Dallas; Cedric V. Pritchett, MD, MPH, Division of Otolaryngology/Audiology, Nemours Children's Hospital, Orlando; Kirk W. Reichard, MD, MBA, Division of Surgery and Pediatrics, Nemours/Alfred I. duPont Hospital for Children; Gresham T. Richter, MD, Department of Otolaryngology–Head and Neck Surgery, Arkansas Children's Hospital; Scott R. Schoem, MD, MBA, Division of Pediatric Otolaryngology, Connecticut Children's Medical Center; Udayan K. Shah, MD, Division of Pediatric Otolaryngology, Nemours/Alfred I. duPont Hospital for Children; Craig Shapiro, MD, Division of Pediatric Infectious Disease, Nemours/Alfred I. duPont Hospital for Children; Kathleen C.Y. Sie, MD, Division of Pediatric Otolaryngology, Seattle Children's Hospital; Richard J.H. Smith, MD, Division of Pediatric Otolaryngology, The University of Iowa Hospital and Clinics; Cecille G. Sulman, MD, Division of Pediatric Otolaryngology, Children's Wisconsin; Dana M. Thompson, MD, MS, MBA, Division of Pediatric Otolaryngology, Ann & Robert H. Lurie Children's Hospital of Chicago; Jerome W. Thompson, MD, MBA, Department of Otolaryngology–Head and Neck Surgery, Le Bonheur Children's Hospital, University of Tennessee Health Sciences Center; Marc C. Thorne, MD, MPH, Division of Pediatric Otolaryngology, University of Michigan; Julie L. Wei, MD, Division of Otolaryngology/Audiology, Nemours Children's Hospital, Orlando. These individuals were not compensated for their contributions.

References
1.
Boulad  F , Kamboj  M , Bouvier  N , Mauguen  A , Kung  AL .  COVID-19 in children with cancer in New York City.   JAMA Oncol. Published online May 13, 2020. doi:10.1001/jamaoncol.2020.2028PubMedGoogle Scholar
2.
Lin  EE , Blumberg  TJ , Adler  AC ,  et al.  Incidence of COVID-19 in pediatric surgical patients among 3 US children’s hospitals.   JAMA Surg. Published online June 4, 2020. doi:10.1001/jamasurg.2020.2588PubMedGoogle Scholar
4.
United States Census Bureau. Combined statistical area population estimates and estimated components of change: April 1, 2010 to July 1, 2019. Published 2020. Accessed May 29, 2020. https://www.census.gov/data/tables/time-series/demo/popest/2010s-total-metro-and-micro-statistical-areas.html
5.
Lu  Y , Li  Y , Deng  W ,  et al.  Symptomatic infection is associated with prolonged duration of viral shedding in mild coronavirus disease 2019: a retrospective study of 110 children in Wuhan.   Pediatr Infect Dis J. 2020;39(7):e95-e99.PubMedGoogle ScholarCrossref
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