Background: Children are generally at low risk of infection and data on COVID-19 in children are scarce. This study was undertaken to document data from a tertiary care hospital in Bangladesh on the incidence, presentation and immediate outcome of COVID-19 in children. Methodology: It was a crosssectional study conducted in the fever clinic and the department of Pediatrics, Bangabandhu Sheikh Mujib Medical University (BSMMU) over a period of one year from July 2020 to June 2021. All the RT–PCR positive pediatric cases (1 month to 18 years) were enrolled. Data were collected by a structured, predesigned and pre-tested questionnaire. Data were analyzed using Microsoft Excel spreadsheet software 2010. Frequency, percentage and chi-square tests were done for statistical analysis. Result: Among 8203 suspected pediatric COVID- 19 cases, 850 (10.36%) was RT PCR positive. The highest number of RT-PCR positive COVID-19 cases was found in April 2021. More than 63% of cases were in the age group of 10 to 18 years. Male: female ratio was 0.97:1. Fever was the most common (75.9%) presenting feature followed by breathing difficulty and chest pain in 9.6% and 7% of patients respectively. Mild infection group was predominant (56.7%). Among the symptomatic cases, 16.7% were hospitalized. Oxygen inhalation and bronchodilators were needed in 75% of hospitalized patients. All the severe and critical cases were managed in the inpatient department and in pediatric PICU when indicated. Most of the patients (99.4%) improved with or without any complication. Four critically ill patients (0.75%) developed multi-organ dysfunction and expired in PICU. Conclusion: The majority of COVID-19 cases belonged to the older age group. More than 75% cases were symptomatic. History of contact was present in 78% cases. More than 99% children recovered with or without sequelae and 0.8% children with pre-existing co-morbidities expired.
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