Pediatric COVID-19 presenting as supraglottitis with vocal cord hypomobility

Abstract

In the United States, an estimated 7.3% of confirmed cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (COVID-19) are among persons aged less than 18 years. Data regarding clinical manifestations in this age group are still evolving. An upper airway predilection has been reported in children. We describe the case of a 15-year-old female with supraglottitis and unilateral hypomobility of vocal cord with concern for critical airway, associated with COVID-19. She was managed by a multidisciplinary team including critical care, infectious diseases, and otolaryngology. This report adds to the sparse but evolving body of literature on the clinical presentation of COVID-19 disease in children.

Croup and COVID‐19

“…In the post‐Hib vaccine era, there are few acute epiglottitis cases, which tend to occur in older children. 3 , 4 , 5 , 6 …”

“…Nadiger et al . 6 describe the first case of supraglottitis with vocal cord hypomobility who needed high dose steroids and nebulised epinephrine for a week; on follow‐up, the patient presented with persistent hoarseness and dysphagia and is, currently, receiving speech therapy. Aghdam et al .…”

“…In the post-Hib vaccine era, there are few acute epiglottitis cases, which tend to occur in older children. [3][4][5][6] SARS-CoV-2 infection has been recently reported to be a rare cause of croup in children. Coronaviruses have been implicated before: Hoek et al 9 described a strong association of human coronavirus NL63 (HCoV-NL63) with croup in young children, being frequently found in young children with lower respiratory tract infections.…”

“…This case report joins the few case reports of severe upper airway disease COVID‐19 related cases, and adds to the growing literature of the SARS‐CoV‐2 clinical presentations. 4 , 5 , 6 , 7 , 8 …”

Patient With Prior COVID-19 Infection Presenting With Acute Upper Airway Obstruction: A Case Report

“…The novel coronavirus disease 2019 (COVID-19) can cause a rapidly progressive respiratory illness and can cause complications involving other major organs [ 1 ]. Limited reports of acute airway compromise, including tonsillitis or epiglottitis, among patients, both adults and children, with COVID-19 have been described and suggest that these may be rare, late complications among COVID-19 patients [ 2 , 3 ]. Acute airway obstruction is a life-threatening event requiring emergent identification and management.…”