We provide early clinical and laboratory data about critical pediatric COVID-19, which suggest a variable disease but generally good outcomes compared with adults. Targets for research include the course of organ failure in pediatric critical COVID-19, laboratory findings for predicting illness course or complications, the inflammatory response and its role in pathophysiology, best treatments, and specific organ involvement, such as myocarditis.

Our findings parallel recent studies describing frequent comorbidities but a short PICU stay and low mortality, contrasting with adults.

Compared to the North American series, our study was international, younger, included only severe disease, and revealed a wider range of common symptoms. We also provide critical COVID-19 laboratory findings.

We found that 3 children had peri-intubation arrest, markedly higher than expected.

At least 1 resulted from unfamiliar protective equipment and intubation processes.

Clinicians must consider the risks before intubating these children.

We enrolled 17 children from 10 PICUs in Chile, Colombia, Italy, Spain, and the United States.

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