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Background The COVID-19 global pandemic caused by severe acute respiratory syndrome coronavirus 2 infection, warranted attention for whether it has unique manifestations in children. Children tend to develop less severe disease with a small percentage present with clinical manifestations of paediatric multisystem inflammatory syndrome and have poor prognosis. We studied the characteristics of COVID-19 in children requiring hospitalisation in the Kingdom of Saudi Arabia and assessed the clinical presentation and the risk factors for mortality, morbidity, and paediatric intensive care (PICU) admission. Methods We conducted a retrospective analysis of COVID-19 patients under 15 years hospitalised at three tertiary academic hospitals between 1 March and 30 June 2020. Results Eighty-eight children were enrolled (>20% were infants). Seven (8%) were in critical condition and required PICU admission, and 4 (4.5%) died of which 3 met the full diagnostic criteria of multi-system inflammatory syndrome and had a high Paediatric Risk of Mortality (PRISM) score at the time of admission. The initial polymerase chain reaction (PCR) test result was positive for COVID-19 in most patients (97.7%), and the remaining two patients had positive result in the repeated confirmatory test. In a subset of patients (20 subjects), repeated PCR testing was performed until conversion to negative result, and the average duration for conversion was 8 (95% CI: 5.2–10.5) days Children requiring PICU admission presented with signs of respiratory distress, dehydration, and heart failure. Most had fever (71.4%) and tonsillitis; 61.4% were discharged within 7 days of hospitalisation. Risk factors for mortality included skin rash, hypotension, hypoxia, signs of heart failure, chest radiograph suggestive of acute respiratory distress syndrome, anaemia, leucocytosis, hypernatraemia, abnormal liver enzymes, and high troponin I, and risk factors for prolonged hospitalisation (>7 days) included the presence of comorbidities, leucopaenia, hyponatraemia, and elevated C-reactive protein. Conclusions The majority of hospitalised children had a brief febrile illness and made a full recovery, but a minority had severe disease.

Introduction and Research Problem: Fever is one of the most common presenting sign of illnesses in pediatric practice. There is no precise test to diagnose bacterial infection rather than blood culture that often has delay results. Our aim is to prove that Procalcitonin is useful in early detection of acute bacterial infection compared to blood culture and CRP in its sensitivity. Materials and methods: In this prospective cohort study, Any sick patient ranging in age from over 1 month to 18 years of age who have a temperature over 38°C was considered at risk of having bacterial infection and were considered eligible for inclusion. Children with recent surgeries, chronic disease, immunodeficiency or took antibiotic within 10 days of presentation, were excluded. also children with important data insufficiency due to incomplete blood measurements were excluded as well. These patients were screened for bacterial infection and we collected demographic data, vital signs, medical histories, reasons for admission and the available laboratory and radiology test results related to their admission.