Croup and COVID-19 in a child: a case report and literature review

Abstract

Croup (laryngotracheitis) is frequently encountered in the emergency department in a young child presenting with stridor. We describe a rare case of croup secondary to SARS-CoV-2 in an 18-month-old child who presented with stridor and respiratory distress and required urgent intubation. Subsequently, the child developed multisystem inflammatory syndrome in children (MIS-C). The child was monitored in paediatric intensive care unit. We would like to highlight that COVID-19 croup in children may be an indicator for MIS-C, and close monitoring is warranted as MIS-C is a life-threatening condition. Our limited experience suggests that COVID-19 croup especially if associated with MIS-C has an underlying more severe pathology and may require prolonged treatment in comparison with the typical croup or even COVID-19 croup. It is important to recognise this clinical entity during a time when most countries are in a third wave of COVID-19 pandemic.

Acute laryngotracheitis caused by COVID-19: A case report and literature review

“…According to a literature review, less common viruses (herpes simplex, herpes zoster, and human immunodeficiency viruses) have been found to cause laryngotracheitis [8] , [9] . Croup has been a presenting feature of COVID-19 in several reported cases in children [10] , [11] , [12] , [13] . To our knowledge, however, laryngotracheitis has not previously been formally reported in adults with COVID-19.…”

Progress in the Diagnosis and Treatment of COVID-19 in Children: A Review

“… 76 Therefore, the possibility of being one of the clinical manifestations of MIS-C should be considered in any child presenting with primary neurological symptoms, accompanied by fever and mild or no respiratory symptoms in an endemic area of COVID-19. In addition, serum albumin levels 13 and croup 80 can also be closely monitored as predictive indicators of MIS-C. Due to most children with MIS-C have mild or no symptoms when initially infected with COVID-19, and high vigilance is needed for MIS-C. 81 …”

COVID-19–Associated Croup in Children

“…Endemic coronaviruses have been linked to croup, however only sparse case reports have described croup specifically associated with SARS-CoV-2 and it remains unclear if croup cases constitute a causative relationship or result of co-infection with another virus. [3][4][5][6] . To address this knowledge gap, we performed a retrospective analysis of the incidence and clinical characteristics of croup associated with SARS-CoV-2 infection at a large freestanding children's hospital.…”