Multiple studies in adults have shown that infection with COVID-19 have increased mortality and pulmonary complication rates in postoperative patients. Data comparing the clinical course of adult and pediatric COVID-19 patients showed that the latter had generally a milder course. However, data for outcomes of COVID-19-infected children who underwent surgery are still lacking especially in the local setting.

This is an analytic cross-sectional study that included all COVID-19 pediatric patients who underwent surgery from 2020 to 2022 in a tertiary government hospital. Mortality rate and postoperative pulmonary complications (PPCs) were the primary and secondary outcomes in the study, respectively. Multiple logistic regression analysis was used to determine the factors associated with mortality and PPCs.

Fifty-five COVID-19 patients were included in the study. PPCs were noted in 22% (n = 12) of patients. One patient (2%) died during the study. Fifty-five percent (n = 30) of patients presented with preoperative pulmonary symptoms and were associated with risk of developing PPCs (adjusted odds ratio [aOR] 3.7 [95% confidence interval 1.27–10.75], P = 0.016). Undergoing a subsequent surgery was also noted to increase risk for PPCs (aOR 29.43 [2.53–342.37], P = 0.007). ASA three patients, patients with allergy, patients needing O2 support and those who were diagnosed with COVID-19 postoperatively were noted to have higher proportions of patients who developed PPCs but were not statistically significant.

Patients with pulmonary symptoms and patients who underwent another procedure were factors noted to be associated with increased risk of developing PPCs.