BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) is a novel pathogen that has rapidly caused a devastating pandemic of Coronavirus disease 2019 (COVID-19). The real time reverse transcriptase polymerase chain reaction cycle threshold values are inversely related to viral load and believed to have a role in terms of mortality and severity of the disease however, there is limited data in children. OBJECTIVES: This study aims to determine the RT-PCR cycle threshold level in relation to mortality and pediatric acute respiratory distress syndrome (pARDS) among COVID-19 patients admitted at Philippine Children’s Medical Center. METHODS: A cross sectional study was done on patients with RT-PCR confirmed covid-19 admitted at Philippine Children’s Medical Center from September 2020 to June 2021. RESULTS: 50 nasopharyngeal swab specimens from children admitted for COVID-19 were analyzed. 12 (24%) had acute respiratory distress syndrome. Among the 12 children who had pARDS, six (50%) expired; in those without pARDS, two (5.26%) expired. There was no difference in cycle threshold values between patients who died and who survived, as well as those with or without pARDS. CONCLUSIONS AND RECOMMENDATIONS We have no evidence to demonstrate a difference in Ct values alone between children who died or survived, or those who developed pARDS or those who did not. RT-PCR cycle threshold alone cannot predict mortality and development of pARDS, it can only indicate the presence of infection but not its severity. Cycle threshold and its significance may further be explored with a bigger population size in children in future studies.