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This retrospective cohort study used the TriNetX research network to identify pediatric patients between 12 and 18 years with COVID\u201019 between January 1, 2022 and August 31, 2023. The propensity score matching (PSM) method was used to match patients receiving NMV\u2010r (NMV\u2010r group) with those who did not receive NMV\u2010r (control group). Two cohorts comprising 633 patients each (NMV\u2010r and control groups), with balanced baseline characteristics, were identified using the PSM method. During the initial 30 days, the NMV\u2010r group showed a lower incidence of all\u2010cause hospitalization, mortality, or ED visits (hazard ratio [HR]\u2009=\u20090.546, 95% confidence interval [CI]: 0.372\u20130.799, <jats:italic>p<\/jats:italic>\u2009=\u20090.002). Additionally, the NMV\u2010r group had a significantly lower risk of all\u2010cause hospitalization compared with the control group (HR\u2009=\u20090.463, 95% CI: 0.269\u20130.798), with no deaths occurring in either group. In the 30\u2013180\u2010day follow\u2010up period, the NMV\u2010r group exhibited a non\u2010significantly lower incidence of post\u2010acute sequelae of SARS\u2010CoV\u20102 infection (PASC), encompassing symptoms such as fatigue, cardiopulmonary symptoms, pain, cognitive impairments, headache, dizziness, sleep disorders, anxiety, and depression, compared to the control group. This study underscores the potential effectiveness of NMV\u2010r in treating high\u2010risk pediatric patients with COVID\u201019, demonstrating significant reductions in short\u2010term adverse outcomes such as emergency department visits, hospitalization, or mortality within the initial 30\u2010day period. 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