This study aims to analyze differences of the prevalence and characteristics of acute lower respiratory infection (ALRI) in children at tertiary hospital before and during COVID-19 pandemic. This was an observational analytic study with cross-sectional design involving pediatric patients based on the time of the study which was in 1 year-prepandemic (A) and 1 year-pandemic period (B). For period A inpatient data were retrieved from medical records and period B used pediatric ALRI registry. The ALRI characteristics were analyzed with significance if P < .05. Prevalence in periods A and B were 5.8% (534/9252) and 4.9% (409/8283), respectively. The characteristics of ALRI for clinical, comorbidities, laboratory findings (NLR, TLC), and chest radiograph showed significant differences ( P < .05). ALRI as manifestation of confirmed COVID-19 were identified in 16 (4.9%) cases. Prevalence of ALRI in children during COVID-19 pandemic is lower compared to before. There are differences in the characteristics of ALRI in pediatrics.

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