Lin EE, Blumberg TJ, Adler AC, et al. - Researchers investigated the incidence of COVID-19 in pediatric patients presenting for surgery at 3 tertiary care children’s hospitals across the United States. At the Children’s Hospital of Philadelphia in Philadelphia, Pennsylvania, Texas Children’s Hospital in Houston, and Seattle Children’s Hospital in Seattle, Washington, screening of all children younger than 19 years without known COVID-19 was performed for COVID-19 after institution of universal preoperative screening for COVID-19. Inclusion of 1,295 pediatric surgical patients was performed; mean (SD) age was 7.35 (5.99) years. Overall incidence of 0.93% was observed for COVID-19 (12 of 1,295). However, hospitals varied significantly in incidence, ranging from 0.22% (1 of 456) to 2.65% (9 of 339). Although patients with COVID-19 exhibited higher tendency to present preoperative symptoms, most notably fever and rhinorrhea, there were no symptoms in half of the patients with positive results. Additionally, there were some of the symptoms that were easily attributed to unrelated conditions (eg, appendicitis). Observations thus suggest symptomatology as an insufficient differentiator in children. According to a recent Pediatric Anesthesia Leadership Council survey of 41 responding centers, universal preoperative screening has been implemented in 56% (Thomas Long, MD, Pediatric Anesthesia Leadership Council, email communication, April 19, 2020). As indicated here, universal screening is of greatest value in areas with higher prevalence. Universal testing should be considered in the context of regional prevalence, local testing capability, and availability of personal protective equipment as resumption of elective surgery occurs across the country.