• Todd J Blumberg, Adam C Adler, Elaina E Lin, Faris Z Fazal, Divya Talwar, Kyle Ellingsen, Arvind Chandrakantan, Jingyang Chen, and Apurva S Shah.
• *Department of Orthopedics and Sports Medicine, Seattle Children's Hospital ∥University of Washington School of Medicine, Seattle, WA †Department of Anesthesiology, Perioperative and Pain Medicine, Texas Children's Hospital, Houston, TX ‡Department of Anesthesiology and Critical Care Medicine §Division of Orthopaedic Surgery, The Children's Hospital of Philadelphia, Philadelphia, PA.
• J Pediatr Orthop. 2020 Nov 1; 40 (10): e990-e993.

BackgroundThe COVID-19 pandemic has substantially altered the typical process around performing surgery to ensure protection of health care workers, patients, and their families. One safety precaution has been the implementation of universal preoperative screening for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This study examines the results of universal screening on children undergoing orthopaedic surgery.MethodsThis is a retrospective cohort study evaluating the incidence and symptomatology of COVID-19 in all patients presenting for orthopaedic surgery at 3 pediatric tertiary care children's hospitals during the COVID-19 pandemic (March to June 2020). All patients underwent universal screening with a nasopharyngeal swab to detect presence of SARS-CoV-2. Bivariate and multivariate logistic regression analysis was performed to identify risk factors for positive COVID-19 screening.ResultsIn total, 1198 patients underwent preoperative screening across all 3 institutions and 7 (0.58%) had detection of SARS-CoV-2. The majority of patients (1/7, 86%) were asymptomatic. Patients that tested positive were significantly more likely to be Hispanic (P=0.046) and had greater number of medical comorbidities (P=0.013), as scored on the American Society of Anesthesiologists (ASA) physical status score. A known COVID-19 positive contact was found to be a significant risk factor in the multivariate analysis (P=0.004).ConclusionsEarly results of universal preoperative screening for COVID-19 demonstrates a low incidence and high rate of asymptomatic patients. Health care professionals, especially those at higher risk for the virus, should be aware of the challenges related to screening based solely on symptoms or travel history and consider universal screening for patients undergoing elective surgery.Level Of EvidenceLevel II.

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