ABSTRACT
BACKGROUND AND AIM: BACKGROUND: Indonesia has experienced two waves of SARS-CoV-2 infection during 2 years of pandemic. The first wave was October 2020 - February 2021 and the second was between May - July 2021. Only few studies comparing the clinical profiles and predictors of severe COVID-19 children between the waves. AIM: To compare the clinical profiles and predictors of severe COVID-19 children between the first and second wave of pandemic. METHOD(S): METHOD: There were 270 children hospitalized with SARSCoV- 2 infection confirmed by RT-PCR during the study period. Twelve children with severe COVID-19 in PICU of 3 hospitals in North Sumatera Indonesia during the first and second waves were enrolled. The data collected were related to clinical characteristics, interventions provided, laboratory findings, and outcomes. RESULT(S): RESULTS: Twelve (4.4%) patients developed severe and critical COVID-19. Eight children in the first wave and the others in the second wave, all of them had comorbidities. Male infants were 50% cases. Fever, cough, dyspnea, and SpO2 < 93% were the most prominent symptoms in first wave cases but neither in the second wave. Low platelet and lymphocyte count with markedly increased C-reactive protein and D-dimer were considered as the predictors of severity. All of the cases were at risk of PARDS with SF ratio below 150. Poor outcome was observed in 87,5% in the first wave versus 25% in the second wave. CONCLUSION(S): CONCLUSION(S): There were major differences comparing the clinical profiles and predictors of severe COVID-19 children between first and second wave of SARS-CoV-2 pandemic.