COVID-19 is Observed in Older Children During the Omicron Wave in New York City.
| Publication Type | Academic Article |
| Authors | Narayanan N, Langer S, Acker K, Rosenblatt S, Simmons W, Wu A, Han J, Abramson E, Grinspan Z, Levine D |
| Journal | J Emerg Med |
| Volume | 64 |
| Issue | 2 |
| Pagination | 195-199 |
| Date Published | 09/19/2022 |
| ISSN | 0736-4679 |
| Keywords | COVID-19, Croup, Respiratory Tract Infections |
| Abstract | BACKGROUND: The Omicron variant of SARS-CoV-2 has a predilection for the upper airways, causing symptoms such as sore throat, hoarse voice, and stridor. OBJECTIVE: We describe a series of children with COVID-19-associated croup in an urban multicenter hospital system. METHODS: We conducted a cross-sectional study of children ≤18 years of age presenting to the emergency department during the COVID-19 pandemic. Data were extracted from an institutional data repository comprised of all patients who were tested for SARS-CoV-2. We included patients with a croup diagnosis by International Classification of Diseases, 10th revision code and a positive SARS-CoV-2 test within 3 days of presentation. We compared demographics, clinical characteristics, and outcomes for patients presenting during a pre-Omicron period (March 1, 2020-December 1, 2021) to the Omicron wave (December 2, 2021-February 15, 2022). RESULTS: We identified 67 children with croup, 10 (15%) pre-Omicron and 57 (85%) during the Omicron wave. The prevalence of croup among SARS-CoV-2-positive children increased by a factor of 5.8 (95% confidence interval 3.0-11.4) during the Omicron wave compared to prior. More patients were ≥6 years of age in the Omicron wave than prior (19% vs. 0%). The majority were not hospitalized (77%). More patients ≥6 years of age received epinephrine therapy for croup during the Omicron wave (73% vs. 35%). Most patients ≥6 years of age had no croup history (64%) and only 45% were vaccinated against SARS-CoV-2. CONCLUSION: Croup was prevalent during the Omicron wave, atypically affecting patients ≥6 years of age. COVID-19-associated croup should be added to the differential diagnosis of children with stridor, regardless of age. © 2022 Elsevier Inc. |
| DOI | 10.1016/j.jemermed.2022.09.036 |
| PubMed ID | 36803448 |
| PubMed Central ID | PMC9482840 |