Journal of the Pediatric Infectious Diseases Society BRIEF REPORT • JPIDS 2020:9 (November) • 617 BRIEF REPORT Received 21 May 2020; editorial decision 25 August 2020; accepted 27 August 2020; Published online August 28, 2020. Correspondence: Ami B. Patel, Division of Pediatric Infectious Diseases, Ann & Robert H. Lurie Children’s Hospital of Chicago, 225 E. Chicago Ave, Box 20 Chicago, IL 60611 (abpatel@ luriechildrens.org). Journal of the Pediatric Infectious Diseases Society 2020;9(5):617–9 © The Author(s) 2020. Published by Oxford University Press on behalf of The Journal of the Pediatric Infectious Diseases Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. DOI: 10.1093/jpids/piaa102 Severe Acute Respiratory Syndrome Coronavirus 2 Point Prevalence Among Asymptomatic Hospitalized Children and Subsequent Healthcare Worker Evaluation Ami B. Patel, 1,2 Andrea Clifford, 1 Julie Creaden, 1 Kimberly Kato, 1 Marcelo R. Malakooti, 1,2 William J. Muller, 1,2 Anna O’Donnell, 1 Sally Reynolds, 1,2 Karen Richey, 1 Jason Rippe, 1 Derek S. Wheeler, 1,2 and Larry K. Kociolek 1,2 1 Department of Pediatrics, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois, USA; and 2 Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA Asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) carriage among hospitalized children and risk of transmission to healthcare workers (HCWs) was evaluated by point prevalence survey. We estimated 1-2% prevalence of SARS-CoV-2 among children without coronavirus disease 2019 symptoms. Tere was no secondary transmission among HCWs exposed to these patients. Key words. asymptomatic; children; COVID-19; health- care worker; SARS-CoV-2. Asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) carriage has been reported during the coronavirus disease 2019 (COVID-19) pandemic [1, 2], but prevalence data are lacking, especially in hospitalized children. Te risk of trans- mission [3] from asymptomatic children remains unknown. We conducted a point prevalence survey for SARS-CoV-2 among hos- pitalized children around the time of predicted peak community COVID-19 activity in Chicago. Our objectives were to charac- terize the prevalence of SARS-CoV-2 in hospitalized children without symptoms of COVID-19, the frequency of secondary infection among healthcare workers (HCWs) exposed to asymp- tomatic children with SARS-CoV-2, and the environmental con- tamination in rooms of asymptomatic children with COVID-19. METHODS Ann & Robert H. Lurie Children’s Hospital of Chicago is a 364- bed free-standing academically afliated children’s hospital. All inpatient children were ofered testing for SARS-CoV-2 over a 2-day period, regardless of clinical concern for COVID- 19 in these patients. On day 1, children in the intensive care units (ICU) were tested. On day 2, children in acute care units were tested. All inpatient children were included with the fol- lowing exceptions: children known to be SARS-CoV-2–pos- itive, children tested within the previous 72 hours because of clinical suspicion for COVID-19 and were SARS-CoV-2–neg- ative, contraindications to obtaining a nasopharyngeal sample, or parents declined participation. Two nurses per unit obtained all specimens on their unit. Nurses participated in an orienta- tion and sample collection competency session to review op- timal nasopharyngeal specimen collection. Each child had 1 nasopharyngeal specimen collected sampling both nares via 1 synthetic fber–focked swab. Te swabs were stored in viral transport media at room temperature until processed by the laboratory within 12 hours of collection. An exposure workup was conducted for all HCWs who had signifcant contact with any patient who tested positive for SARS-CoV-2 on our point prevalence. A signifcant exposure was considered as being within 6 feet of the patient for at least 10 minutes without appropriate personal protective equipment (PPE). For patients who tested positive for SARS-CoV-2, ap- propriate PPE would have been a standard face mask, eye pro- tection, gown, and gloves for routine care and N95 (instead of standard face mask) if an aerosol-generating procedure was performed. Universal masking for HCWs and visitors with a level 1 procedure face mask provided by the hospital was on- going at the time of this study. Family members were asked to wear a level 1 procedure mask provided by the hospital when HCWs entered patient rooms, but patients were not masked in their inpatient room. Of note, universal eye protection for HCWs was not in place at the time of this survey. Consequently, although masks were required at all times for HCWs, eye pro- tection was not. To evaluate contamination of hospital rooms of children with COVID-19, we sampled the environment of children identifed on this point prevalence survey as well as the inpatient rooms of known COVID-19–positive children for comparison. Samples were collected with premoistened synthetic fber–focked swabs with viral transport media. Downloaded from https://academic.oup.com/jpids/article/9/5/617/5898532 by guest on 17 April 2021