OBJECTIVE: Our objective was to evaluate the risk of urinary tract infection (UTI) and bacteremia in infants 1 year or less of age infected with COVID-19. METHODS: This was a retrospective study from TriNetX database in the United States. This study was from March 11, 2020, to May 11, 2023, during the COVID-19 pandemic. Patients were included if they were infants, 1 year or less, had a fever, and had a COVID-19 polymerase chain reaction test 1 week before or after presentation to the emergency department (ED) or hospital. We compared outcomes of bacteremia and a UTI in those with COVID-19 and those without COVID-19. Propensity matching was done to account for the confounders of age, gender, race, immune disorders, genitourinary abnormalities, preterm birth, and circumcision. RESULTS: Infants who were positive for COVID-19 were at a reduced risk of UTI and bacteremia. There was a significant decreased risk of having a UTI if one had COVID-19 (1.0%) versus those without COVID-19 (2.3%) (risk ratio = 0.37, 95% confidence interval = 0.37-0.50, P <
0.001). For bacteremia, there was also a decreased risk if the infant had COVID-19 (0.4%), versus those without COVID-19 (0.5%) (risk ratio = 0.74, 95% confidence interval = 0.56-0.97, P = 0.03). CONCLUSIONS: Infants with fever found to have COVID-19 had lower risks of UTI and bacteremia.