COVID-19 pre-procedural testing strategy and early outcomes at a large tertiary care children's hospital

Pediatr Surg Int. 2021 Jul;37(7):871-880. doi: 10.1007/s00383-021-04878-2. Epub 2021 Mar 14.


Purpose: With the emergence of the coronavirus disease-2019 (COVID-19) pandemic, institutions were tasked with developing individualized pre-procedural testing strategies that allowed for re-initiation of elective procedures within national and state guidelines. This report describes the experience of a single US children's hospital (Children's Wisconsin, CW) in developing a universal pre-procedural COVID-19 testing protocol and reports early outcomes.

Methods: The CW pre-procedural COVID-19 response began with the creation of a multi-disciplinary taskforce that sought to develop a strategy for universal pre-procedural COVID-19 testing which (1) maximized patient safety, (2) prevented in-hospital viral transmission, (3) conserved resources, and (4) allowed for resumption of procedural care within institutional capacity.

Results: Of 11,209 general anesthetics performed at CW from March 16, 2020 to October 31, 2020, 11,150 patients (99.5%) underwent pre-procedural COVID-19 testing. Overall, 1.4% of pre-procedural patients tested positive for COVID-19. By June 2020, CW was operating at near-normal procedural volume and there were no documented cases of in-hospital viral transmission. Only 0.5% of procedures were performed under augmented COVID-19 precautions (negative pressure environment and highest-level personal protective equipment).

Conclusion: CW successfully developed a multi-disciplinary pre-procedural COVID-19 testing protocol that enabled resumption of near-normal procedural volume within three months while limiting in-hospital viral transmission and resource use.

Keywords: COVID-19; Pediatric; Pre-procedure; Testing.

MeSH terms

  • COVID-19 / epidemiology*
  • COVID-19 / transmission
  • COVID-19 Testing / statistics & numerical data*
  • Child
  • Elective Surgical Procedures / statistics & numerical data
  • Female
  • Hospitals, Pediatric / organization & administration*
  • Humans
  • Male
  • Pandemics / prevention & control
  • SARS-CoV-2
  • Tertiary Healthcare / organization & administration
  • Wisconsin / epidemiology