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Researchers have found evidence the SARS-CoV-2 omicron variant may cause croup in children.
A team from Boston Children’s Hospital looked at data on children treated at their institution for both COVID-19 and croup since the start of the pandemic. Children with croup have a swollen larynx and trachea and may have a barking cough and difficulty breathing.
Since the start of the pandemic, 75 children at the hospital have been diagnosed with COVID-19-associated croup, and 81% of cases occurred during the omicron period. Only one of the children tested positive for another virus, according to “COVID-19 Associated Croup in Children,” (Brewster RCL, et al. Pediatrics. March 8, 2022).
About 12% of the children were hospitalized, and they spent a median of 1.7 days in the hospital. Four children required intensive care.
Nearly all patients were treated with dexamethasone. All hospitalized patients and about one-quarter of emergency department patients also had racemic epinephrine. Hospitalized patients received a median of six dexamethasone and eight racemic epinephrine doses.
Authors said the data present “compelling evidence” that the SARS-CoV-2 omicron variant causes croup, and the croup cases may be more severe when linked to omicron than with other viruses. Omicron’s tendency to strike the upper airway may help explain the connection.
“Further research is needed to characterize the underlying mechanisms of COVID-19-associated croup, differences in clinical features from other viral etiologies, and appropriate management strategies in the SARS-CoV-2 era,” they wrote.