According to a hospital study, the omicron coronaviruses variant caused a spike in cases of a potentially severe breathing condition in babies and toddlers.
The study only looked at cases at a large children's hospital in Massachusetts during the Pandemic. It provides some of the initial data on the subject and backs up anecdotes from health care providers that the latest variant causes more cases of laryngotracheobronchitis in younger children than earlier versions.
croup is a common upper-respiratory tract condition in which inflammation and swelling can endanger breathing. Croup can be triggered by a variety of factors, including allergies and viral infections. It can happen at any age but strikes the tiny upper airways of infants and young children.
Croup gets its name from the cough it causes, which is sometimes described as a seal-like barking cough. When a patient breathes in respiratory distress and a harsh grating sound, it's a sign of the condition.
It didn't seem to be a common outcome of the Pandemic infection of COVID-19, which was associated with some children. During the omicron wave, healthcare providers reported seeing more COVID-19 associated croup cases in young patients.
Experts theorize that early versions of the SARS-CoV-2 tended to target the lower respiratory tract, leading to more severe disease in older age groups. Omicron seems to have a preference for the upper-respiratory tract, which may explain why it is more transmissible and associated with milder illnesses in older age groups.
Omicron appears to pose a new risk in young children who are ineligible for the vaccine because of their small airways.
AdvertisementThe researchers scanned the records of the hospital for COVID-19 associated croup cases from March 2020 to January 2022. They only found 75 cases, but 61 of them occurred during the roughly month-and-a-half time frame of the omicron wave.
Between March 2020 and the start of December 2021, there were 14 COVID-19-associated croup cases, with no more than one case in a week. Twelve of the cases went to the emergency department and two of them were hospitalized. At the peak of the omicron surge in Massachusetts, there were around two dozen cases in one week. Fifty-four of the 61 cases went to the emergency department and seven were hospitalized.
There was no other peak that was related to the spike in croup cases. In the cases where doctors tested the children for possible infections, all the children tested negative except for one who tested positive for a cold.
The researchers noted that the cases of COVID-19-associated croup were more severe than those caused by other viral infections. More hospitalizations and more re-dosing of treatments were caused by the COVID-19-associated croup. Four of the cases required intensive care.
For non-COVID-19-associated cases, croup can sometimes be managed at home with simple treatments and over-the-counter medicines. Experts recommend bringing a baby or toddler with a cold or flu to a warm bathroom or outside on a cold night. The cold and moist help loosen mucus. In cases where a young child is struggling to breathe, a trip to the emergency department can provide quick relief with a steroid, such as the glucocorticoid dexamethasone, to decrease inflammation.
Although the Massachusetts study is limited by its small size and single location, the authors argue that it offers compelling preliminary evidence that omicron infections can cause severe croup.
Two years into the COVID-19 pandemic, the pathogenicity, infectiousness, and manifestations of new variant of SARS-CoV-2 have been dynamic and unique.
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