Abstract
Numerous factors contributed to coronavirus 2019 (COVID-19) disease recovery and death rates. In many countries, socioeconomics, morbidities, the experience of symptoms and access to healthcare services are major contributors to recovery and death rates. A retrospective cohort study was conducted to determine the morbidity, mortality, survival probability, and risk factors associated with COVID-19 among children in the Free State province, South Africa. A total of 846 patients' records were used in the study. Using SPSS version 28 software, survival probability was determined using Kaplan-Meier estimation curves and Cox regression was used to determine the effect of sociodemographics and clinical manifestation information on time of death. The COVID-19 mortality rate was 13.12% in our study. There were more female patients (60%) than male patients (40%). In total, 71 patients had two or more morbidities, while 414 patients were asymptomatic. Patients between 5 and 18 years old were at twice the risk of dying of COVID-19, and male children were at a higher risk as well. Having more than one symptom was also a risk for dying in this study. Severe COVID-19 is attributed to numerous factors, and these are closely associated with surrounding environments and public health systems. The findings are important for the clinical management of similar diseases and circumstances in the future.