To the Editor-Understanding the prevalence of coinfections with coronavirus disease 2019 (COVID-19) is crucial to delineating its true clinical impact. Numerous studies have evaluated coinfections in adults with COVID-19, 1-3 but data on pediatric COVID-19 coinfections are limited. Here, we evaluate the burden of coinfections in pediatric COVID-19 patients at 2 large Chicagoland medical centers. Methods We retrospectively reviewed electronic health records of all pediatric patients tested for severe acute respiratory coronavirus virus 2 (SARS-CoV-2) from March 9, 2020, through April 30, 2020, in 2 Chicagoland medical centers. At the University of Chicago Medicine, SARS-CoV-2 was diagnosed using one of the following real-time reverse transcriptase polymerase chain reaction (RT-PCR) assays on respiratory specimens: Cobas SARS-CoV-2 RT-PCR assay (Roche Basel, Switzerland) or Xpert Xpress SARS-CoV-2 test (Cepheid, Sunnyvale, CA). Respiratory coinfections were primarily identified using a multiplex RT-PCR respiratory viral panel (RVP) with the following targets: adenovirus, coronavirus 229E/HKU1/NL63/OC43, human metapneumovirus, influenza-A/-B, parainfluenzas 1-4, respiratory syncytial virus, Mycoplasma pneumoniae, Chlamydophila pneumoniae, Bordetella pertussis, and rhinovirus/enterovirus (FilmArray Respiratory Panel, BioFire Diagnostics, Salt Lake City, UT). Coinfections were also identified using the influenza/respiratory syncytial virus (RSV) RT-PCR assay (Cepheid Xpert Xpress Flu/RSV) known as the influenza/RSV panel (IRP). At NorthShore University HealthSystem, SARS-CoV-2 was identified similarly using RT-PCR: Xpert Xpress or BD Max (Becton Dickinson, Franklin Lakes, NJ). Coinfections were detected using a multiplex RT-PCR panel that contained only the viral targets of the RVP (GenMark Dx, GenMark Diagnostics, Carlsbad, CA), as well as an IRP (Roche Cobas Liat Influenza A/B and RSV). We included all RVPs and IRPs that were obtained within 7 days of a SARS-CoV-2 test.