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Croup and COVID-19 in a child: a case report and literature review

Chee Chean Lim1, Jeyasakthy Saniasiaya2, Jeyanthi Kulasegarah1

  • 1Department of Otorhinolaryngology, Faculty of Medicine, University of Malaya, Kuala Lumpur, WP Kuala Lumpur, Malaysia.

BMJ Case Reports
|September 15, 2021
PubMed

Insights

A rare case of croup in an 18-month-old child linked to SARS-CoV-2 (COVID-19) also led to multisystem inflammatory syndrome in children (MIS-C). This suggests COVID-19 croup may indicate MIS-C, a serious condition requiring close monitoring.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Croup (laryngotracheitis) is a common emergency department presentation in young children, characterized by stridor.
  • SARS-CoV-2 (COVID-19) has emerged as a potential cause of respiratory illness in children, including croup.
  • Multisystem inflammatory syndrome in children (MIS-C) is a rare but serious post-infectious complication associated with COVID-19.

Observation:

  • An 18-month-old child presented with stridor and respiratory distress, diagnosed with croup secondary to SARS-CoV-2.
  • The child required urgent intubation due to severe respiratory distress.
  • Following intubation, the child developed multisystem inflammatory syndrome in children (MIS-C) and was managed in the pediatric intensive care unit.

Findings:

  • COVID-19-associated croup can be a presenting sign for MIS-C in children.
  • Children with COVID-19 croup complicated by MIS-C may exhibit a more severe disease course.
  • This presentation may necessitate prolonged medical treatment compared to typical croup or uncomplicated COVID-19 croup.

Implications:

  • Recognizing COVID-19 croup as a potential indicator for MIS-C is crucial for early diagnosis and intervention.
  • Close monitoring of children with COVID-19 croup is warranted due to the risk of developing MIS-C.
  • This clinical entity highlights the diverse and potentially severe manifestations of SARS-CoV-2 infection in pediatric populations, especially during pandemic waves.

Keywords:
COVID-19paediatricsrespiratory medicine

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