A retrospective review of 123 consecutive patients (< 18 years) with prior polysomnogram (PSG) and COVID-19 testing from Cleveland Clinic's COVID-19 registry was conducted. Obstructive sleep apnea (OSA) was not associated with increased SARS-CoV-2 positivity: 1.20 (0.1, 3.47, P = 0.74). No significant difference between cases and controls for median AHI 2.8 (1.2, 5.6) vs 3.2 (1.5, 6.1), P = 0.64, SpO2 nadir 89.5 ± 0.5 vs 88.4 ± 6.3, P = 0.30, %time SpO2 < 90%, P = 0.29, respectively, was noted. WHO-7 COVID-19 clinical outcomes did not meet statistical significance in relation to OSA due to the low event frequency. Of note, those with OSA vs without OSA had a higher WHO-7 outcome score of 2 vs 0 and prevalence of hospitalization: 13.3% vs 0%, respectively. Of hospitalized patients, the following was observed: 23% had moderate/severe OSA vs 4.3% mild OSA, 50% required supplemental oxygen, and 25% required intubation/invasive ventilation. No deaths or readmissions were reported. High risk conditions included 75% obesity, 50% asthma, 25% sickle cell disease, and 25% hypoplastic left heart.