Abstract Background: Nutrition has important role in the regulation of optimal immune functions, as it provides proper nutrients such as minerals, and vitamins, as well as macronutrients in ad-equate concentrations to immune system. however, nutritional deficiencies are associated with impaired immune response and have negative impact on human resistance to infection. Aim of Study: Evaluation of the nutritional status of criti-cally ill pediatric patients diagnosed with COVID-19 admitted to PICU and study correlation between nutritional deficiency and outcome. Patients and Methods: This retrospective cohort study of hospitalized patients with COVID-19 enrolled at the pediatric intensive care unit of El-Galaa Teaching Hospital. All con-firmed COVID-19 patients have been screened in the period be-tween June 1st, 2023 and may 31th, 2024. The study reviewed the demographic data, anthropometric data, nutritional and medical history, laboratory investigation, duration of hospital stays and outcome of the hospitalized patients during the period of the study. Results: A total of 60 patients with COVID-19 aged 2 to 10 years were evaluated in this study. Non-survivors' patients with COVID-19 had significantly lower anthropometric meas-urements (Z score for weight, Z score for height and body mass index Z score) as compared to survivors. There was statistical-ly decrease in folic acid, Vitamin D, Zinc, Selenium (38.3%, 23.3%, 65%, 36.7% respectively) in COVID-19 patients. While severe vitamin D deficiency was reported in 21.7% of patients. There was statistically significant decrease in folic acid, Vita-min D, Zinc, Selenium innon- survivors as compared with sur-vivors'patients. Also, there was statistically significant increase in duration of hospital stay innon-survivors' patients. Conclusion: Pediatric patients with COVID-19 may have nutritional deficiency in one or more micronutrients that may affect their immune response to infection, severity of disease, complications and duration of hospitalization. They will bene-fit from screening and supplementation of vitamins and trace elements.