COVID-19 croup under Omicron – Boston Children’s Answers
COVID-19 croup under Omicron – Boston Children’s Answers

COVID-19 croup under Omicron – Boston Children’s Answers

Doctors at Boston Children’s describe 75 cases of croup and give advice to parents. (Photo: AdobeStock)

During the Omicron rise, pediatricians and emergency departments (EDs) began to notice something new: an increase in cross among infants and toddlers. Marked by a characteristic “barking” cough and sometimes noisy, loud breathing, ticks can occur when colds and other viral infections cause the voice box, trachea and bronchi to become inflamed and swollen.

Doctors at Boston Children’s decided to take stock, looking back at their records of children with ticks and COVID-19. In a report in journals Pediatricsthey provide the first rigorous description of the COVID-19-related croup reviewing the cases of 75 children who came to the ED.

The review stretched back to the beginning of the pandemic, but 80 percent of the children arrived during the Omicron climb. “There was a very clear increase when Omicron became the dominant variant,” says the study leader Dr. Ryan Brewsterresident i Boston Combined Residency Program in Pediatrics.

A snapshot of COVID croup

Some of the croup cases at Boston Children’s were surprisingly severe, requiring more medication doses than usual and leading to more hospital admissions than expected. Consistent with the usual cross pattern, most of the children were under 2 years of age and about 70 percent were boys. Except for one child with the common cold virus, had no virus infection other than COVID-19.

Although no children died, nine of the children (12 percent) had difficulty breathing and had to be hospitalized. Four of the nine (44 percent) required intensive care. By comparison, before COVID-19, fewer than 5 percent of children with croup were hospitalized, according to a medical examination. Of those, only 1 to 3 percent had to be intubated.

“Most cases of croup can be treated in the ED or pediatrician’s office with steroid dexamethasone and supportive care,” says Dr. Brewster. “Our relatively high hospitalization rate and the number of treatments hospitalized children needed – an average of six doses of dexamethasone and eight treatments with nebulized adrenaline – suggest that COVID-19 can cause more severe croup than other viruses. We need more research for to determine the best treatment options for these children. “

Why do all these cases of COVID-19 creep appear?

Evidence from several laboratory studies suggests that the Omicron variant mainly attacks the upper respiratory tract – the neck and bronchi – while previous strains were mainly directed at the lungs, says Dr. Brewster. While these studies were on animals, it seems likely that the same is true for humans.

What if my child has a cross?

You can take care of mild tick at home by sitting with your child while inhaling cool mist from a humidifier or steam from a hot shower for 15-20 minutes. A favorite song or book can help relieve your child’s anxiety, which can aggravate crossover symptoms.

However, the following signs should ask for a call to your pediatrician and possibly a visit to the emergency room:

  • frequent noisy inhalations and barking coughs at rest (when your child is calm and not moving)
  • obvious breathing problems: soak the sternum or ribs, use the abdominal muscles to help breathe, dazzle the nostrils
  • increased fatigue or drowsiness
  • blue lips or blue fingertips
  • a temperature higher than 100.4 ° F for more than three days
  • symptoms of mild ticks lasting longer than seven days

If my child has a tick, does that mean they also have COVID-19?

Is it possible. “While many viruses can cause ticks, you should also consider the possibility that your child has COVID-19,” he says. Dr. Jonathan Mansbach, who is head of Hospital Medicine at Boston Children’s and oversaw the study. “Consider having them and other family members tested, especially if there is reason to believe they have been detected.”

Learn more about COVID-19 research at Boston Children’s

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