Prevalence of COVID-19-related croup up during omicron

The proportion of children with COVID-19-related croup was increased during the period of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) omicron predominance compared with alpha or other variant- and delta-predominant periods, according to a research letter published online July 1 in JAMA Network Open.

Brian Lefchak, M.D., M.P.H., from Children's Minnesota in Minneapolis, and colleagues conducted a cross-sectional study to examine whether SARS-CoV-2 variants were associated with the proportion of children with croup among children aged 3 months to 8 years. Data were included for 5,152 children with diagnoses of COVID-19 and croup between Jan. 1, 2021, and March 26, 2022.

The researchers found that compared with alpha or other variant and delta periods, the proportion of children with COVID-19-related croup was significantly increased during the omicron period (10.9 percent versus 4.1 and 3.6 percent, respectively). The odds of hospitalization were not significantly different during periods of alpha or other variant or delta predominance versus omicron predominance. Compared with the period of omicron predominance, treatment with racemic epinephrine was less likely during the period of delta predominance and did not differ in the period of alpha or other variant predominance. There was no statistically significant difference observed in the frequency of intensive care unit admission across the time periods.

"Given that COVID-19 is likely to become endemic, our findings suggest that pediatric health systems should consider variation in SARS-CoV-2 phenotypes and their association with patient care," the authors write. "This may be especially true when other viral infections lead to surges in patient volume."

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