Croup (laryngotracheobronchitis) is an infection of the upper respiratory tract, seen especially in children under 6 years old. During the Omicron wave, 75 children hospitalized in Boston were reportedly diagnosed with Covid associated with croup. Symptoms, treatment… Decryption of this childhood disease with Dr Jonathan Rozental, pediatrician.
[Mis à jour le 18 mars 2022 à 9h56] While the first variants of Covid caused infections of the lower respiratory tract, the Omicron variant appears to attack the upper respiratory tract. Since the latter are relatively smaller in children than in adults, this could lead to more severe clinical presentations resembling laryngotracheobronchitisalso called croupsay researchers in a study conducted at the hospital Boston (Massachusett, USA) published on March 8, 2022 in the journal Pediatrics. Between March 1, 2020 and January 15, 2022, 75 children, hospitalized in Boston, were diagnosed with Covid associated with croup, 81% of them during the Omicron wave. Most patients were male (72%) and aged less than 2 years old and 88% required admission to an emergency department. Caused by an inflammation of the respiratory tract of viral origin such as Covid in this case, croup is classically characterized by a sudden barking cough, inspiratory stridor, and respiratory distress. Regarding treatment, 97% of them received dexamethasone. 4 patients required intensive care and no child died. “The incidence of croup co-occurring with SARS-CoV-2 infection increased sharply in December 2021, strongly correlating with the emergence of the Omicron variant. Other COVID-19 spikes were not associated with increased croup diagnoseswould like to reinstate the authors of the study. Our preliminary results provide compelling evidence for the hypothesis that the Omicron variant causes laryngotracheobronchitis“. What is this disease? What are the warning symptoms? How to treat it quickly?
Definition: what is croup?
Croup, or the “faux croup” – a word used when the disease affects children under five – are outdated terms, little used today by paediatricians. Croup, faux croup… We are actually talking about a “acute viral infection of the upper respiratory tract (trachea or larynx), which mainly affects children between the ages of three and five”informs the pediatrician interviewed, or of a laryngotrachéobronchite.
What are the symptoms of croup?
“It’s hard to ignore these symptoms.” warns Dr. Jonathan Rozental. Namely:
- fever,
- a cold,
- difficulty breathing (dyspnea),
- noisy breathing,
- an abnormal, hoarse and barking cough, similar to a seal cry very characteristic of this pathology.
- In some cases, the child may have difficulty swallowing, sweating, or the extremities and lips are a little blue
- If he refuses to lie down, it is because he is having difficulty breathing in a position other than that in which he is half-sitting, he also warns.
The adults have few symptoms if they are infected. As for the little ones babiesthey will have “the nose stuck and difficult to finish their bottle, but they will not tend to cough”, enlightens the Doctor.
What causes croup?
The causes are viral. These infections are caused by winter viruses, such as laryngitis virus, influenza virusor pharyngitis.
While the symptoms of croup can be impressive, the infection is easily cured.
Is croup contagious?
“Like all viruses, croup is contagious. It spreads through sneezing or coughing, especially in the first days of infection.” You should consult quickly: “From the first identifiable signs, the child must be taken to his pediatrician or to the pediatric emergency room” informs Doctor Jonathan Rozental. An ENT can also be consulted, but not a pulmonologist, “since it is a question of high asphyxia”.
How is croup diagnosed?
“The diagnosis is purely clinical. The doctor first listens to the child’s cough. He then takes the constants: he observes the respiratory rate, heart rate, temperature and blood pressure”says the doctor specializing in the care of children. “There are no other prescribed examinations, no blood tests or x-rays”, he reassures, once again.
Treatment: how is croup treated?
The young patient will be prescribed corticosteroidsto be taken for about 5 days, and which reduce inflammation. “If he is having a lot of trouble breathing, the doctor can give him some adrenaline (unless he has tachycardia) in order to constrict the vessels. He will then have to breathe what comes out of the aerosol”, clearly explains the interviewee who wants to reassure the parents. If the symptoms of croup can be impressive, the infection is easily treated: “If the child is taken care of quickly enough – and this will be the case as his symptoms are identifiable, unless the parents are obviously malicious – the treatment will be rapid and well tolerated. He will heal quickly, and will have no complications or sequelae.”
Thanks to Doctor Jonathan Rozental, pediatrician at the Wagram Santé medical center, in the 17th arrondissement of Paris.
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