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

Affiliations
  • 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. pedyang@schmc.ac.kr
  • 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. jy7.shim@samsung.com
  • 26Department of Pediatric Allergy & Pneumology, Catholic University Uijeongbu St. Mary's Hospital, Uijeongbu, Korea.

Abstract

PURPOSE
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.
METHODS
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.
RESULTS
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%).
CONCLUSION
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.

Keyword

Child; Croup; Hospitalization; Retrospective studies; Seasons

MeSH Terms

Child*
Coronavirus
Croup*
Demography
Electronic Health Records
Hospitalization
Humans
Korea
Male
Mycoplasma
Paramyxoviridae Infections
Polymerase Chain Reaction
Respiratory Syncytial Viruses
Retrospective Studies*
Reverse Transcription
Rhinovirus
Seasons*

Figure

  • Fig. 1. Pathogens detected in hospitalized children with croup between 2010 and 2015. A total of 927 children with croup were hospitalized between 1 January 2010 through 31 December 2015. Among them, most prevalent age group was <2 years old (n=584, 63.0%). Most commonly detected pathogen was parainfluenza virus under the age of 4 years. MP, Mycoplasma pneumoniae; AdV, adenovirus; RV, human rhinovirus; Flu, influenza virus; PIV, parainfluenza virus; HMPV, human metapneumovirus; RSV, respiratory syncytial virus; BoV, bocavirus; CoV, coronavirus.

  • Fig. 2. Numbers of hospitalized children with croup and pathogen-detected croup between 1 January 2010 through 31 December 2015, according to month and year. A total of 2,598 hospitalized children with croup were identified. Among them respiratory pathogens were detected in 927 children.

  • Fig. 3. Distribution of pathogen-detected croup between 1 January 2010 and 31 December 2015, according to month and year. (A) Pathogens detected in hospitalized children with croup. (B) Distribution of PIV, and PIV subtypes. (C) Distribution of CoV and CoV subtypes. AdV, adenovirus; HRV, human rhinovirus; Flu, influenza virus; PIV, parainfluenza virus; HMPV, human metapneumovirus; RSV, respiratory syncytial virus; BoV, bocavirus; HCoV, human coronavirus.


Cited by  1 articles

Etiology of respiratory virus in croup with children in Korea
Jeong Hee Kim
Allergy Asthma Respir Dis. 2019;7(2):65-66.    doi: 10.4168/aard.2019.7.2.65.


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