Lin EE, Blumberg TJ, Adler AC, et al. - Researchers investigated the incidence of coronavirus disease 2019 (COVID-19) in pediatric patients presenting for surgery at 3 tertiary care children’s hospitals across the United States. Screening for COVID-19 was performed in all children younger than 19 years without known COVID-19, after institution of universal preoperative screening for COVID-19 at the Children’s Hospital of Philadelphia in Philadelphia, Pennsylvania, Texas Children’s Hospital in Houston, and Seattle Children’s Hospital in Seattle, Washington. Assessment of 1,295 pediatric surgical patients [mean (SD) age: 7.35 (5.99) years] was performed in this study. They observed an overall COVID-19 incidence of 0.93% (12 of 1,295). However, the incidence varied greatly between the regions represented by the hospitals and even by township within the catchment area of a single hospital. While patients with COVID-19 were more likely to have preoperative symptoms, most notably fever and rhinorrhea, there were half of the patients with positive results who had no symptoms. In addition, some of the symptoms observed were easily attributed to unrelated conditions (eg, appendicitis). Hence, they identified symptomatology as an insufficient differentiator in children. There are reports of asymptomatic children who had high viral load. If present, symptoms tended to be mild in children. Findings establish the greatest significance of universal screening in areas with higher prevalence. With the resumption of elective surgery across the country, it is imperative to consider universal testing in the context of regional prevalence, local testing capability, and availability of personal protective equipment.