J Korean Med Sci.  2022 May;37(20):e140. 10.3346/jkms.2022.37.e140.

Croup as a Manifestation of SARSCoV-2 Omicron Variant Infection in Young Children

• Choi YY
• Kim YS
• Lee SY
• Sim J
• Choe YJ
• Han MS

• KMID: 2530102
• DOI: http://doi.org/10.3346/jkms.2022.37.e140

Abstract

Croup is an acute upper respiratory disease primarily caused by the parainfluenza virus. Owing to inflammation and edema of the upper airways, children present with barky cough and stridor, and some may experience respiratory distress. We investigated children aged < 5 years with coronavirus disease 2019 (COVID-19) admitted to two hospitals in Seoul, South Korea, and observed a spike in croup cases during the omicron surge. Among the 569 children admitted from March 1, 2021 to February 25, 2022, 21 children (3.7%) had croup, and the proportion of croup cases was significantly higher during the omicron wave than that during the delta wave (12.4% vs. 1.2%, P < 0.001). With the immediate administration of corticosteroids and epinephrine via nebulizer, the symptoms improved rapidly. During the current omicron surge, careful monitoring of the symptoms of croup in young children is needed for the diagnosis of COVID-19 and its timely management.

Keyword

Croup; Children; SARS-CoV-2; COVID-19; Omicron

Figure

• 

  Fig. 1 Croup due to SARS-CoV-2 infection in children < 5 years. (A) Monthly cases of COVID-19 in children < 5 years and monthly detection rate of respiratory viruses. With the sharp rise in the number of COVID-19 cases in Seoul, South Korea during the omicron wave, the proportion of croup cases admitted to two hospitals in Seoul significantly increased. The parainfluenza virus did not circulate in South Korea between January and February 2022. (B) Neck radiography of a 28-month-old child with COVID-19 presenting with severe croup. Subglottic narrowing is noted (arrow, left) and with medical treatment the airway became patent after 18 hours (arrowhead, right).COVID-19 = coronavirus disease 2019.

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