Abstract
Background:Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused over 6 million deaths worldwide. Comorbidities like obesity, asthma, and neurological disorders are risk factors for severe illness in pediatric patients. The direct impact of COVID-19 on child mortality is limited, with only 0.4% of deaths occurring in children under 20.
 Objective: To identify risk factors and potential interventions to reduce severe illness and mortality in pediatric patients.
 Methods:A systematic review of COVID-19, sars-cov-2, and novel coronavirus in children was conducted using PubMed and Google Scholar. Severe COVID-19 prevalence in children assessed using Strengthening the Reporting of Observational Studies in Epidemiology (STROME) and the Joanna Briggs Institute (JBI) checklists, assessing quality and bias.
 Results:A review of 41 studies found a significant difference in severe COVID-19 infection risk among children with and without comorbidities, including hematologic, immune, respiratory, cardiovascular, neurological, obesity, and genetic syndromes.
 Conclusion:Comorbidities in pediatric COVID-19 patients enhance the risk; vaccinations and increased vigilance should take priority. 
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