Background Coronavirus disease (COVID-19) is an emerging infectious disease affecting people of all ages, races, and countries, caused by the severe acute respiratory syndrome coronavirus (SARS-CoV-2). The disease has been shown to be more lethal in select individuals with existing comorbidities and inflammation. Although the disease occurs in people of all ages, a milder course has been observed in pediatric patients. Evidence suggests that the burden of COVID-19 infection is lower in hospitalized children than in their adult counterparts. To date, there are few reports describing the factors responsible for acute COVID-19 severity in young adults and their differences in the elderly. In this work, we aimed to review the factors responsible for determining the most severe cases with chronic clinical manifestations by evaluating their clinical presentations to close the gap and provide a potential basis to address this relationship between severity and age. The lower severity in young adults could be due to a variety of reasons, ranging from immunologic factors to genetic composition. Our work helps classify some of these factors, which appear to play a role in a small number of critical cases. The characteristic ability of the younger human body to fight this deadly disease may be a striking feature when trying to manage patients belonging to the older age group. Setting All settings, including hospitalized and community settings. Patients Children and young people (CYP) under 20 years of age with PCR and other laboratory tests COVID -19 affected patients. Main results: Prevalence of symptoms and signs of COVID -19. Purpose There are limited data on the demographics and clinical features of SAR -CoV-2 infection in children. Therefore, with this literature review, we aim to uncover various factors responsible for the different severities in pediatric patients. This will help us to better understand COVID -19 in different age groups.