• J Emerg Med · Feb 2023

    Multicenter Study

    COVID-19 is Observed in Older Children During the Omicron Wave in New York City.

    • Nisha Narayanan, Samantha Langer, Karen P Acker, Steven D Rosenblatt, Will Simmons, Alan Wu, Jin-Young Han, Erika L Abramson, Zachary M Grinspan, and Deborah A Levine.
    • Department of Emergency Medicine; Department of Pediatrics. Electronic address: nin9034@med.cornell.edu.
    • J Emerg Med. 2023 Feb 1; 64 (2): 195199195-199.

    BackgroundThe Omicron variant of SARS-CoV-2 has a predilection for the upper airways, causing symptoms such as sore throat, hoarse voice, and stridor.ObjectiveWe describe a series of children with COVID-19-associated croup in an urban multicenter hospital system.MethodsWe 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).ResultsWe 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.ConclusionCroup 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.Copyright © 2022 Elsevier Inc. All rights reserved.

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