Croup Is One of the Clinical Manifestations of Novel Coronavirus in Children

Abstract

The manifestations of novel coronavirus are diverse and can manifest through respiratory, gastrointestinal, and even nervous symptoms. Respiratory involvement is usually an upper tract infection or pneumonia but can also present as other forms of pulmonary disorders. A 3-year-old boy presented with cough, hoarseness, and stridor. He was treated with dexamethasone and nebulized adrenaline and a clinical diagnosis of croup was established. After treatment, his symptoms improved for a short time, but suddenly cough exacerbated and was accompanied by respiratory failure and seizures. He was then intubated and mechanically ventilated. Because of the coronavirus epidemic, Reverse-Transcription Polymerase Chain Reaction (RT-PCR) assay was taken from the pharyngeal secretions and was positive. The child was isolated. Due to excessive respiratory secretions and worsening of the general condition, bronchoscopy was performed depicting an image compatible with bacterial tracheitis. He was treated with broad-spectrum antibiotics, antivirals, and supportive care. Finally, after 4 weeks of treatment, the child was discharged in good general condition. Croup is one of the respiratory symptoms of novel coronavirus and can be a risk factor for bacterial tracheitis. Therefore, the presence of clinical manifestations of croup indicates the need for coronavirus PCR testing.

Croup as a Manifestation of SARS-CoV-2 Omicron Variant Infection in Young Children

“…Sporadic case reports published before the omicron wave suggested a possible association of croup with SARS-CoV-2 in children. 4 5 6 7 16 Moreover, we have observed a few cases of croup in children with COVID-19 before the omicron surge in Korea. However, a sharp increase in the number of children presenting with croup symptoms became evident during the omicron surge.…”

“…2 Sporadic case reports suggest severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as a pathogen responsible for croup, and many clinicians have observed spikes in croup cases during the current omicron (B.1.1.529) wave. 3 4 5 6 7 8 9 10 Herein, we report a recent sharp rise in pediatric coronavirus disease 2019 (COVID-19) cases requiring hospitalization due to croup during the omicron surge in Seoul, South Korea.…”

An Unexpected Cause of Croup in a Pediatric Patient

“…13 Another case describes a 3-year-old boy with respiratory failure and secondary bacterial tracheitis from SARS-CoV-2-positive croup. 14 Similar to many other respiratory viruses, COVID-19 testing can remain positive for several weeks after acute infection with SARS-CoV-2, introducing the possibility that a patient's positive test does not represent acute infection.…”

Aerosolized drug delivery in awake and anesthetized children to treat bronchospasm

“…Dexamethasone is known to reduce croup symptoms, shorten hospital stays and reduce the rate of return visits. However, it is noted that further investigations are required to determine the optimal management of “COVID‐19 croup.” 74,77 …”

“…However, it is noted that further investigations are required to determine the optimal management of "COVID-19 croup." 74,77…”