Introduction Coronavirus 2019 (SARS-CoV-2) infection in children occurred in Peru as of March 2020, leading to pediatric patients' hospitalization in areas adapted for this purpose at the Edgardo Rebagliati Martins National Hospital. In the beginning, the demand for hospitalization was low, but it increased gradually. Consistent with international reports, the majority of patients presented mild or moderate symptoms. Nonetheless, there were also severe cases, even fatal ones. Objectives To describe the characteristics and clinical outcome of pediatric patients with COVID-19 hospitalized in a referral hospital in Lima, Peru, between March and August 2020. Methods A descriptive and inferential cross-sectional study was carried out. The population includes all hospitalized patients in the Department of Pediatrics, with clinical and surgical diagnoses associated with COVID-19. Results We included 100 patients, with an average age of 83.4 ± 54 months, with a predominance of male patients (55%). Hospitalized patients were grouped into five categories: respiratory failure (17%), multisystemic inflammatory syndrome (MIS-C) (31%), neurological presentation (19%), acute abdomen (20%), and patients with oncological problems (13%). Most of the patients (74%) had comorbidities. Regarding the presenting symptoms, intestinal pain predominated in the appendicitis group (90%, p < 0.001), fever was present in most patients with respiratory failure (64.7%); multisystemic inflammatory syndrome (90.3%), neurological manifestations (15.8%), acute abdomen (50%) and oncological conditions (61.5%) were also present in these patients. Kawasaki symptoms were found in 38.7% of the patients with multisystemic inflammatory syndrome. Mortality was 4%. Respiratory problems (29.4%) and multisystemic inflammatory syndrome (22.6%) required admission to intensive care, more frequently than the other presentations (p = 0.008). Conclusions We conclude that the vulnerability in the pediatric population is the one that has preexisting conditions. We divided our patients according to presentation, diagnosis, and complications, which were predominantly respiratory. We also had oncological patients with COVID-19.

El síndrome inflamatorio multisistémico pediátrico asociado a COVID-19 (SIM-C) es una entidad poco frecuente y heterogénea, potencialmente fatal. Existen pocos reportes de casos de esta enfer- medad y de sus fenotipos en Latinoamérica. Objetivo: Describir las características de los fenotipos clínicos en pacientes hospitalizados en Lima, Perú, con diagnóstico de SIM-C. Pacientes y Método: Estudio retrospectivo de pacientes < 14 años con diagnóstico de SIM-C en el Hospital Nacional Edgardo Rebagliati Martins, Lima, Perú, abril 2020 - agosto 2021. Se registraron variables clínico- demográficas y microbiológicas. Según éstos, se clasificó a los pacientes con SIM-C en el fenotipo shock, enfermedad de Kawasaki (EK) sin shock, y el fenotipo fiebre e inflamación, analizando sus re- sultados clínicos. Resultados: Se incluyeron 58 pacientes, 32 (55,2%) presentaron el fenotipo shock, 15 (25,8%) el fenotipo EK sin shock, y 11 (19%) el fenotipo fiebre e inflamación. Del fenotipo shock, 17 presentaron EK. La edad media fue de 7 ± 3,5 años y el 67,2% eran varones. Las manifestaciones gastrointestinales y mucocutáneas predominaron en todos los fenotipos. La mortalidad fue de 3,5%. La frecuencia de aneurismas coronarios fue del 10,2%. La mayoría de los pacientes recibió trata- miento inmunomodulador y antiplaquetario. Los pacientes con fenotipo shock presentaron mayor disfunción hematológica, inflamatoria y cardiaca, con mayor frecuencia de insuficiencia respiratoria y ventilación mecánica invasiva. Conclusiones: En nuestra serie de casos, los pacientes con fenotipo shock fueron los más frecuentes y presentaron peores desenlaces clínicos. Se necesita una vigilancia activa de los fenotipos clínicos para un diagnóstico y manejo precoz con el fin de mejorar el pronós- tico en estos pacientes.

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Objective: Describe the clinical-epidemiological profile and determine the factors associated with unfavorable outcomes of pediatrics multisystemic inflammatory syndrome (SIM-P) related to COVID-19 at Edgardo Rebagliati Martins National Hospital (HNERM), Lima-Perú, from April to September 2020. Materials and methods: Retrospective cohort in children under 14 years of age. The current criteria were used for the diagnosis of SIM-P. The effect size was estimated with relative risk (RR) and 95% confidence intervals, using a generalized linear Poisson family model with robust variance. Results: 43 patients were included, 22 (51.2%) Kawasaki Disease (EK), 10 (23.3%) shock, and 11(25.6%) fever with inflammatory markers. The median age was 8 years, most men, without comorbidity, with negative molecular test and positive IgG. Gastrointestinal and mucocutaneous manifestations predominated, with altered inflammatory markers and myocardial injury. Most required intravenous immunoglobulin (IVIG), aspirin (AAS), corticosteroids and antibiotics. More than a third required VMI, ICU and developed organic dysfunction, with a lethality of 4.6% (2/43). Increasing lethality to 20% (2/10) in the shock subgroup. Five were found (14.7%) coronary aneurysm. Having some comorbidity (RR 1.79; IC95%1.02-3.14), C-reactive protein ≥ 10 mg/dL (RR 2.09; IC95%1.15-3.79), and SatO2 ≤92 in emergency (RR 2.84; IC95%1.47-5.50) was morelikely to betransferred to ICU. In addition, those with some comorability (RR 2.23; IC95%1.04-4.79), with lymphopenia <500cel/mL (RR 2.8; IC95%1.24-6.30), and with d≥ 3 mg/L (RR 3.57; IC95%1.23-10.38) were more likely to require VMI. Conclusion: Active monitoringis an eye to make early diagnosis and management in order to improve the prognosis.