Allergy Asthma Respir Dis.  2019 Apr;7(2):78-85. 10.4168/aard.2019.7.2.78.

Seasonal patterns and etiologies of croup in children during the period 2010–2015: A multicenter retrospective study

  • 1Department of Pediatrics, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea.
  • 2Department of Pediatrics, Asthma and Allergy Center, Inje University Sanggye Paik Hospital, Seoul, Korea.
  • 3Department of Pediatrics, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea.
  • 4Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
  • 5Department of Pediatrics, Pusan National University Yangsan Hospital, Yangsan, Korea.
  • 6SCH Biomedical Informatics Research Unit, Soonchunhyang University Seoul Hospital, Seoul, Korea.
  • 7Department of Pediatrics, Dankook University Hospital, Cheonan, Korea.
  • 8Department of Pediatrics, Yonsei University Severance Hospital, Seoul, Korea.
  • 9Department of Pediatrics, Soonchunhyang University Gumi Hospital, Gumi, Korea.
  • 10Department of Pediatrics, Inje University Haeundae Paik Hospital, Busan, Korea.
  • 11Department of Pediatrics, Korea University Guro Hospital, Seoul, Korea.
  • 12Department of Pediatrics, Eulji University Eulji General Hospital, Seoul, Korea.
  • 13Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea.
  • 14Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 15Department of Pediatrics, Hanyang University Guri Hospital, Guri, Korea.
  • 16Department of Pediatrics, Chonnam National University Hospital, Gwangju, Korea.
  • 17Department of Pediatrics, National Health Insurance Service, Ilsan Hospital, Ilsan, Korea.
  • 18Department of Pediatrics, Daegu Catholic University Medical Center, Daegu, Korea.
  • 19Department of Pediatrics, Chungnam National University Hospital, Daejeon, Korea.
  • 20Department of Pediatrics, Dongguk University Gyungju Hospital, Gyungju, Korea.
  • 21Department of Pediatrics, Sowha Children's Hospital, Seoul, Korea.
  • 22Department of Pediatrics, Seoul National University Children Hospital, Seoul, Korea.
  • 23Department of Pediatrics, CHA University CHA Bundang Medical Center, Seongnam, Korea.
  • 24Department of Pediatrics, Soonchunhyang University Seoul Hospital, Seoul, Korea.
  • 25Division of Pediatric Allergy & Pulmonology, Department of Pediatrics, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Korea.
  • 26Department of Pediatric Allergy & Pneumology, Catholic University Uijeongbu St. Mary's Hospital, Uijeongbu, Korea.


Croup is known to have epidemics in seasonal and biennial trends, and to be strongly associated with epidemics of parainfluenza virus. However, seasonal and annual epidemics of croup have not been clearly reported in Korea. This study aimed to examine the seasonal/annual patterns and etiologies of childhood croup in Korea during a consecutive 6-year period.
Pediatric croup data were collected from 23 centers in Korea from 1 January 2010 to 31 December 2015. Electronic medical records, including multiplex reverse transcription polymerase chain reaction (RT-PCR) results, demographics and clinical information were cross-sectionally reviewed and analyzed.
Overall, 2,598 childhood croup patients requiring hospitalization were identified during the study period. Among them, a total of 927 who underwent RT-PCR were included in the analysis. Males (61.5%) predominated, and most (63.0%) of them were younger than 2 years of age (median, 19 months; interquartile range, 11-31 months). Peak hospitalization occurred in 2010 and 2012 in even-numbered years, and parainfluenza virus (PIV, 39.7%) was the most common cause of childhood croup requiring hospitalization, followed by respiratory syncytial virus (14.9%), human rhinovirus (12.5%), Mycoplasma pneumonaie (10.6%), and human coronavirus (7.3%).
It is concluded that croup hospitalization has a biennial pattern in even-numbered years. PIV may be the most common cause of childhood croup; however, croup epidemics could be attributed to other viruses.


Child; Croup; Hospitalization; Retrospective studies; Seasons

MeSH Terms

Electronic Health Records
Paramyxoviridae Infections
Polymerase Chain Reaction
Respiratory Syncytial Viruses
Retrospective Studies*
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