Department of Emergency Medicine; Department of Pediatrics.
Department of Pediatrics.
J Emerg Med. 2023 Feb;64(2):195-199. doi: 10.1016/j.jemermed.2022.09.036. Epub 2022 Sep 19.
The Omicron variant of SARS-CoV-2 has a predilection for the upper airways, causing symptoms such as sore throat, hoarse voice, and stridor.
We describe a series of children with COVID-19-associated croup in an urban multicenter hospital system.
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).
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.
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.
SARS-CoV-2 的奥密克戎变体偏爱上呼吸道，引起喉咙痛、声音嘶哑和喘鸣等症状。
我们描述了在城市多中心医院系统中患有 COVID-19 相关哮吼的一系列儿童病例。
我们对 COVID-19 大流行期间急诊科就诊的≤18 岁儿童进行了横断面研究。数据取自一个由所有接受 SARS-CoV-2 检测的患者组成的机构数据存储库。我们纳入了哮吼诊断符合国际疾病分类第十版编码且在就诊后 3 天内 SARS-CoV-2 检测阳性的患者。我们比较了奥密克戎流行前（2020 年 3 月 1 日至 2021 年 12 月 1 日）和奥密克戎流行期间（2021 年 12 月 2 日至 2022 年 2 月 15 日）患者的人口统计学、临床特征和结局。
我们确定了 67 例哮吼患儿，其中 10 例（15%）发生在奥密克戎流行前，57 例（85%）发生在奥密克戎流行期间。与流行前相比，奥密克戎流行期间 SARS-CoV-2 阳性患儿的哮吼患病率增加了 5.8 倍（95%置信区间 3.0-11.4）。奥密克戎流行期间≥6 岁的患儿比例高于流行前（19% vs. 0%）。大多数患儿未住院（77%）。奥密克戎流行期间≥6 岁的患儿接受肾上腺素治疗的比例更高（73% vs. 35%）。大多数≥6 岁的患儿无哮吼病史（64%），仅有 45%接种过 SARS-CoV-2 疫苗。
奥密克戎流行期间哮吼较为常见，异常影响≥6 岁的患儿。对于有喘鸣的患儿，无论年龄大小，均应将 COVID-19 相关哮吼纳入鉴别诊断。© 2022 Elsevier Inc.
