The increase in Omicron cases has led to an unrecognized-until-now complication of COVID-19 in young children, laryngitis. It is the most common cause of acute upper airway obstruction in infants and preschoolers.
Specifically, doctors at Boston Children's Hospital described 75 cases of children who presented to the hospital's Emergency Department with laryngitis and COVID-19 from March 1, 2020 to January 15, 2022, according to a report seen through Pediatrics. Specifically, the cases recorded were laryngotracheitis. When the narrowing involves only the larynx, we refer to laryngitis, while when it extends to the trachea, which is a continuation of the larynx, we refer to laryngotracheitis.
Laryngitis is a common respiratory disease found mostly in infants and young children. It is characterized by severe coughing and noisy inhalations. It is caused when colds and other viral infections cause inflammation and swelling. Its symptoms start with sniffles and dry step, with or without fever, and vary from child to child. It is usually manifested by difficult breathing, a characteristic sound when the child inhales (wheezing), a hoarse voice and an irritating, paroxysmal cough (like a dog barking). The symptoms are similar to those of other infections so clinical examination by a paediatrician is particularly important. In severe cases such as those seen in Boston, it can lead to dangerous breathing difficulties. Their duration, however, varies but does not exceed seven days.
Some of the cases of laryngitis with coronavirus were considered particularly important, requiring hospitalization and increased use of medication compared to laryngitis from other causes.
According to Ryan Brewster, author of the report and a Boston pediatrics resident, the COVID-19 animal studies found that the new Omicron variant has a preference for the upper respiratory tract, compared to other variants that primarily targeted the lower respiratory tract. This is why laryngitis is temporally associated with the increase in cases due to Omicron.
Study findings
According to the general pattern of the disease, most children with COVID-19 and laryngitis were under 2 years of age and 72% of them were boys. Although no children were lost, however, 9 of the 75 children with laryngitis due to COVID-19 required hospitalization and four of them needed intensive care.
[BRB][BRB]Overall, 97% of the children were given dexamethasone, a steroid. All of the hospitalized children received racetamine epinephrine via nebulizer, which is reserved for moderate or severe cases. Those hospitalized needed an average of 6 doses of dexamethasone and 8 respiratory treatments of epinephrine to control symptoms.
"Most cases can be treated on an outpatient basis with dexamethasone and supportive care," Brewster said. "The relatively high hospitalization rate and the large number of drug doses needed suggested that COVID-19 may cause more severe laryngitis than other viruses" , but more research is needed to treat it much more promptly.
Advice to parents
Parents can care for children with mild laryngitis symptoms at home by sitting next to their child while they inhale water vapour, but should visit a paediatrician if symptoms do not subside and become more severe such as:
- Frequent noisy inhalations and severe paroxysmal coughing
- Difficulty breathing
- Fatigue and drowsiness
- Blue lips or fingertips
- Fever above 38 degrees Celsius
Symptoms lasting more than 7 days
Source: ygeiamou.gr
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