A new study from Boston Children’s Hospital has found that the omicron variant of COVID-19 has been associated with a spike in severe croup, a viral respiratory infection. Between early January 2020 and mid-January 2022, a total of 75 children ages one to three at a large free-standing children’s hospital in Boston were diagnosed with croup associated with COVID-19. Of those children, 81% showed symptoms during the recent outbreak of omicron cases, which researchers classified as dating to mid-April 2021 (when the first case of omicron was reported in Massachusetts).
“There was a very clear spike when the omicron became the dominant variant,” said study leader Ryan Brewster, MD, resident of the Boston Combined Residency Program in Pediatrics. recently said in a statement. However, it is important to note some of the limitations of the study, namely the small sample size – only 75 children were followed in a hospital. While this means more research is needed, this is the first investigation into croup associated with COVID-19 and may help us better understand the risks COVID-19 poses to young children.
According to Mayo Clinic, croup is a viral infection of the upper respiratory tract, which obstructs breathing and causes a barking cough of sudden onset. Symptoms include swelling around your voice box, trachea, and bronchi (two large tubes that carry air from your windpipe to your lungs). It is common in infants and young children aged six months to three years and can usually be treated at home. However, if the symptoms are severe (such as the child having difficulty breathing or being unable to swallow) or if the symptoms persist for more than three to five days, it is important to see a doctor. In the United States, croup affects approximately 3% of children each year.
Of the 75 children analyzed in the study, four required intensive care, and one child required continuous positive airway pressure. Fortunately, none of the children in the study died. “Our relatively high hospitalization rate and the number of treatments that hospitalized children need – an average of six doses of dexamethasone and eight treatments with nebulized epinephrine – suggest that COVID-19 may cause more severe croup than other viruses, » Dr Brewster said.
As COVID-19 has evolved and mutated into different variants, the medical community’s understanding of its effects on children has also changed. Typically, young children who have been infected with the virus (particularly the delta variant) have had milder symptoms than adults, but in recent months omicron has led to children aged four and younger being hospitalized at a rate five times higher than when the delta variant was dominant, according to the Centers for Disease Control and Prevention (CDC). The Boston Children’s Hospital researchers suggest this is because « early variants typically caused lower respiratory tract infections, with the recently identified omicron variant possibly exhibiting a predilection for the upper respiratory tract. » In children, the upper airways are smaller than those of adults and therefore can make them more vulnerable to more serious cases of respiratory diseases such as croup.