Pediatric croup with COVID-19

Copyright © 2021 Elsevier Inc. All rights reserved..

We describe three previously healthy children, admitted from our emergency department (ED) to our free-standing children's hospital, as the first documented cases of croup as a manifestation of SARS-CoV-2 infection. All three cases (ages 11 months, 2 years, and 9 years old) presented with non-specific upper-respiratory-tract symptoms that developed into a barky cough with associated stridor at rest and respiratory distress. All were diagnosed with SARS-CoV-2 by polymerase chain reaction testing from nasopharyngeal samples that were negative for all other pathogens including the most common etiologies for croup. Each received multiple (≥3) doses of nebulized racemic epinephrine with minimal to no improvement shortly after medication. All had a prolonged period of time from ED presentation until the resolution of their stridor at rest (13, 19, and 21 h). All received dexamethasone early in their ED treatment and all were admitted. All three received at least one additional dose of dexamethasone, an atypical treatment occurrence in our hospital, due to each patient's prolonged duration of symptoms. One child required heliox therapy and admission to intensive care. All patients were eventually discharged. Pathogen testing is usually not indicated in croup, but with "COVID-19 croup," SARS-CoV-2 testing should be considered given the prognostic significance and prolonged quarantine implications. Our limited experience with this newly described COVID-19 croup condition suggests that cases can present with significant pathology and might not improve as rapidly as those with typical croup.

Media Type:

Electronic Article

Year of Publication:

2021

Contained In:

The American journal of emergency medicine - Vol. 43 (2021), p. 287.e1-287.e3

Language:

English

Contributors:

Venn, April M R
Schmidt, James M
Mullan, Paul C

Links:

Volltext

Keywords:

COVID-19
Case Reports
Child
Child, Preschool
Comorbidity
Croup
Emergency department
Female
Humans
Infant
Male
Pediatric
RNA, Viral
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2
Stridor

Notes:

Date Completed 11.05.2021

Date Revised 11.05.2021

published: Print-Electronic

Citation Status MEDLINE

Copyright: From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Physical Description:

Online-Ressource

doi:

10.1016/j.ajem.2020.09.034

PMID:

32980228

PPN (Catalogue-ID):

NLM316472077