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Prevalence of COVID-19 and Risk Factors for Infection Among Pediatric Anesthesia Patients: A Report From the PEACOC
Meredith A Kato1, David Zurakowski2, AmandaMarie Adams1
1From the Department of Anesthesiology & Perioperative Medicine, Doernbecher Children's Hospital, Oregon Health & Science University, Portland, Oregon.
Insights
Pediatric anesthesia patients had lower COVID-19 rates than the general population. Risk factors for infection in children undergoing anesthesia were identified, including race, ethnicity, and obesity.
Area of Science:
- Pediatric Anesthesiology
- Infectious Diseases
- Epidemiology
Background:
- The Pediatric Anesthesia COVID-19 Collaborative (PEACOC) network was established to improve pediatric care during the pandemic.
- This study aimed to determine COVID-19 prevalence in children undergoing anesthesia and identify risk factors.
Purpose of the Study:
- Calculate COVID-19 prevalence in pediatric anesthesia patients.
- Compare prevalence with general population data (CDC).
- Assess independent risk factors for COVID-19 infection in this cohort.
Main Methods:
- Multicenter, retrospective, observational study.
- Included children (28 days–18 years) undergoing anesthesia with universal COVID-19 testing.
- Analyzed trends using Cochran-Armitage test and risk factors using multivariable logistic regression.
Main Results:
- 33,320 anesthesia encounters analyzed; 265 children tested positive for COVID-19.
- Pediatric anesthesia patients showed no significant trend in infection rates.
- General population showed a significant downward trend in infection rates (P < .001).
- Risk factors identified: Black/African American race, Hispanic ethnicity, ASA status III+, overweight/obese BMI, orthopedic/abdominal/emergency cases, West region.
Conclusions:
- COVID-19 rates were lower in pediatric anesthesia patients compared to the general population.
- Identified independent risk factors for positive COVID-19 tests in children.
- This study represents the first large-scale universal testing for a single infectious disease in this population, revealing unprecedented associations with surgical case type and emergency status.
Background:
The Pediatric Anesthesia COVID-19 Collaborative (PEACOC) is a research network to advance the care of children during the pandemic. Here we calculate the prevalence of coronavirus disease 2019 (COVID-19) among children undergoing anesthesia, look at prevalence in the population data from the Centers for Disease Control and Prevention (CDC), and assess independent risk factors for infection.
Methods:
This was a multicenter, retrospective, observational study. Children aged 28 days to 18 years scheduled for anesthesia services at 12 centers requiring universal COVID-19 testing from March 29, 2020 to June 30, 2020 were included. COVID-19 positivity rates among those tested were plotted and trends were assessed using the Cochran Armitage test of trend. Independent risk factors were explored using multivariable logistic regression.
Results:
Data were collected and analyzed on 33,320 anesthesia encounters including 265 children with COVID-19. Over the study period, the rates of infections in the pediatric anesthesia population did not demonstrate a significant trend. In the general population, there was a significant downward trend in infection rates ( P < .001). In exploratory analysis, multivariable risk factors for a COVID-19 positive test were Black/African American race, Hispanic ethnicity, American Society of Anesthesiologists (ASA) physical status III or above, overweight and obese body mass index (BMI), orthopedic cases, abdominal cases, emergency cases, absence of injury and trauma, and West region (all P < .05).
Conclusions:
Rates of COVID-19 in pediatric anesthesia patients were consistently lower than in the general population. Independent risk factors of a positive test for children were identified. This is the first time universal testing for a single infectious disease was undertaken on a wide scale. As such, the association of infection with surgical case type or emergency case status is unprecedented.
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