eng Science and Education Publishing American Journal of Medical Case Reports 2374-216X 2022-01-23 10 2 29 34 10.12691/ajmcr-10-2-3 AJMCR20221023 article Adegoke Oluwakemi T aktpillar@yahoo.com 1 Bamigboye-Taiwo Olukemi T 1 Afeniforo Olufunke G 1 Okeniyi John A 1 Omotoye Babatunde S 2 Olorunmoteni Oluwatosin E 2 Adegoke Adedokun I 3 Department of Paediatrics, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria Department of Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria Department of Obstetrics and Gynaecology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria COVID-19 is a disease which originated in China in 2019 and has rapidly spread to become a pandemic. COVID-19 is less common in children and young adults and cases among this group of individuals are usually not as severe as in the elderly, the immunocompromised or those with co-morbidities. Research of COVID-19 in children is not as robust as in adults probably due to the aforementioned reason. We report four cases of COVID-19 in children who had mild to severe disease course. These children had other co-morbid illnesses such as malaria, bacterial sepsis and rheumatic heart disease. Two of these children had rarer severe complications of the disease hardly reported in children, these were; pleural effusion and cholestatic liver disease. It may be important to screen every child that requires hospital admission for COVID-19 in order to make early diagnosis of the disease and to commence appropriate therapy where necessary. This may forestall development of complications including death in such children. http://pubs.sciepub.com/ajmcr/10/2/3/ajmcr-10-2-3.pdf COVID-19 sepsis cholestatic jaundice malaria pleural effusion rheumatic heart disease