Introduction COVID-19 clinical course, effective therapeutic regimen, and poor prognosis risk factors in pediatric cases are still under investigation and no approved vaccinehas been introduced for them. Methods This cross-sectional study evaluated different aspect of COVID-19 infection in hospitalized COVID-19 positive children (≺18 years oldwith laboratory confirmed COVID-19 infection, using the national COVID-19 registry for all admitted COVID-19 positive cases from February 19 until November 13,2020, in Iran. Results We evaluated 6610 hospitalized children. Fifty-four percent (3268) were male and one third of them were infants younger than 1 year. Mortality rate in total hospitalized children was 5.3% and in children with underlying co-morbidities (14.4%) was significantly higher (OR: 3.6 [2.7-4.7]). Chronic kidney disease (OR: 3.42 [1.75-6.67]), Cardiovascular diseases (OR: 3.2 [2.09-5.11]), chronic pulmonary diseases (OR: 3.21 [1.59-6.47]), and diabetes mellitus (OR: 2.5 [1.38-4.55]), resulted in higher mortality rates in hospitalized COVID-19 children. Fever (41%), cough (36%), and dyspnea (27%) were the most frequent symptoms in hospitalized children and dyspnea was associated with near three times higher mortality rate among children with COVID-19 infection (OR: 2.65 [2.13-3.29]). Conclusion Iran has relatively high COVID-19 mortality in hospitalized children. Pediatricians should consider children presenting with dyspnea, infants≺ 1 year and children with underlying co-morbidities, as high-risk groups for hospitalization, ICU admission, and death. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-021-03030-2.
【저자키워드】 COVID-19, Mortality, Epidemiology, children, Iran, 【초록키워드】 Hospitalized, Hospitalization, cross-sectional, Infection, Diabetes Mellitus, Symptom, risk factor, cough, Laboratory, cardiovascular, Infant, Clinical course, COVID-19 infection, Dyspnea, therapeutic, male, ICU admission, death, co-morbidity, Kidney disease, mortality rate, group, disease, co-morbidities, COVID-19 mortality, chronic, regimen, supplementary material, poor prognosis, chronic pulmonary disease, Confirmed COVID-19 infection, National, positive, hospitalized COVID-19, Pediatric case, effective, Result, evaluated, approved, introduced, significantly higher, presenting, children with COVID-19, Pediatrician, 【제목키워드】 Hospitalized, poor prognosis, Pediatric case, Red,