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Pediatricians: COVID-19 in young children could look like croup

Pediatricians say they are seeing an increase in children younger than 5 years old with croup-like symptoms who test positive for COVID-19, according to MedPage Today.

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Dr. Eric Ball, a pediatrician at Children’s Health Orange County in Southern California, said that he started seeing more cases of omicron in younger children before Christmas, and those children came in with the barking coughs that generally characterize croup.

“Croup is one of many things that we are seeing these kids present with,” Ball explained.

The symptoms of omicron in younger children can look like croup with a barky cough, difficulty breathing and fever, Susan Wu, a pediatric hospitalist at the Children’s Hospital Los Angeles said.

“In general, we don’t get a lot of hospitalizations for croup. It’s something that usually we can manage in the emergency (department) and we might have a handful of hospitalizations,” Wu said. “But I have seen several patients admitted with croup due to COVID in the last couple of weeks... That is unusual.”

Dr. John Lukeman, a pediatrician at Warren Clinic Pediatrics in Tulsa, Oklahoma, told The Tulsa World that he is seeing a significant increase in the number of cases of the omicron variant in his patients, especially those younger than age 4.

“This is becoming an increasingly worrisome state for our pediatric patients,” Lukeman said.

“In my office last week, we had a day that our (COVID-19) positivity rate was 85%, and we had another day where it was 92%, so the number of patients that we’re seeing in our pediatric offices are drastically increased, and this is worrisome,” he said.

“So from the beginning of omicron, they were saying this was a more transmissible variant. But everyone was saying it was a mild variant, as well. Interestingly, that’s not necessarily what we’re seeing in pediatrics. We’re seeing an increase in hospitalizations; we’re seeing our patients under 4 years old have croup-like symptoms, requiring either steroids or breathing treatments to help them to breathe.”

Dr. Buddy Creech, a pediatric infectious disease expert and director of the Vanderbilt University Vaccine Research Program, says croup likely happens in younger children because omicron appears to settle higher in the upper respiratory tract.

“Little kids’ airways are so narrow that it takes far less inflammation to clog them,” Creech said.

Croup is an infection of the upper airway which obstructs breathing and creates a barking cough. Croup is not uncommon in younger children and is generally not dangerous.

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