This study evaluated the impact of COVID-19 on 382 children and adolescents (<21 years) exposed to SARS-CoV-2 through the collection of exposure, demographic, and clinical records in North Carolina. Compared to uninfected children, SARS-CoV-2 infected children were more likely to be Hispanic (88% vs. 57%) and have an infected sibling (49% vs 29%), but they were less likely to have asthma (6% vs. 17%). Adolescents (13-21 years) were more likely to experience flu-like symptoms (61% vs 39%), have gastrointestinal symptoms (27% vs. 9%), and experience sensory symptoms (42% vs. 9%). Comparing asymptomatic and symptomatic children, there was no significant difference in age associated with nasopharyngeal viral load. The findings of this study indicate the need to further explore the factors associated with SARS-CoV-2 infection and illness in children of different ages.