The coronavirus disease 2019 (COVID-19) pandemic has impacted people of all ages. Although children have been largely spared from the direct impact of the pandemic and only a minority of children affected with SARS-CoV-2 infection or the associated hyper-inflammatory syndrome require admission to a paediatric intensive care unit (PICU) [1], paediatric healthcare has been affected in a myriad of other ways. In this article, we review the indirect impact of the pandemic on PICU. It is important to note that the literature on this theme is constantly evolving and findings vary according to geography, demographic and potentially phase of the pandemic.