Croup associated with COVID-19: A case series

Area of Science:

• Pediatric Emergency Medicine
• Infectious Diseases
• Respiratory Illnesses

Background:

• Croup (laryngotracheobronchitis) incidence decreased during early COVID-19 pandemic lockdowns.
• A resurgence of croup cases, particularly associated with the Omicron variant, has been observed.
• Limited data exists on severe or treatment-refractory COVID-19-associated croup in children.

Purpose of the Study:

• To characterize the clinical presentation and outcomes of pediatric croup linked to the Omicron variant.
• To focus on identifying and describing cases of croup refractory to standard treatments.
• To provide insights into managing severe COVID-19-associated croup in children.

Main Methods:

• A case series design was employed.
• Included children aged 0-18 years diagnosed with croup and COVID-19.
• Data collected from a children's hospital ED in the Southeastern US (December 2021 - January 2022).

Main Results:

• 81 patient encounters were analyzed.
• Most patients (72.8%) were discharged from the emergency department.
• 19 patients (23.5%) required hospital admission, with 3.7% admitted to the ICU.
• Compared to pre-pandemic, a wider age range, higher admission rates, and fewer coinfections were noted.

Conclusions:

• COVID-19-associated croup with the Omicron variant presents across a wide age range.
• While most cases had favorable outcomes with low revisit rates, some refractory cases require careful management.
• Findings emphasize the need for tailored management strategies for severe pediatric croup during viral surges.