Levin et al. performed cross sectional analyses of 5,364 pediatric (19 years and younger) COVID-19 hospitalizations in 22 different states to examine severity and spread of COVID-19 among this population. The average cumulative hospitalization rate in this study increased from 2 per 100,000 children in the beginning of the study to 17.2 of 100,000 children. The highest pediatric hospitalization rates at the beginning of the study were found in New Jersey (5.0 per 100,000) and Colorado (4.4 per 100,000); however, by the end of the study, the highest rates shifted to South Dakota (33.7 per 100,000) and Arizona (32.8 per 100 ,000). The lowest pediatric hospitalization rates at the start of the study were found in Hawaii and Rhode Island (both 0 per 100,000) but at the end of the study New Hampshire replaced Rhode Island at 1.0 per 100,000 and Hawaii increased to 4.3 per 100,000 hospitalizations. Several states saw significant growth and variance including Utah from 0.3 to 15.5 per 100,000 hospitalizations. This study suggests that pediatric hospitalizations may offer reasons for concern.