Croup (due to viruses) has surged with Omicron - March 2022

Omicron linked with croup in babies March 21, 2022 MDEdge

  • "From the start of the pandemic until mid-January 2022, emergency physicians at Boston Children’s Hospital treated 75 children with croup, all but one of whom had COVID infections. Eighty percent of those cases occurred after Omicron began circulating in December 2021"


COVID-19-Associated Croup in Children March 8, 2022 Pediatrics PDF

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Croup at kidshealth.org

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Most cases of croup are caused by contagious viruses like parainfluenza, adenovirus, or respiratory syncytial virus (RSV). Viral croup is most common — and symptoms are most severe — in children 6 months to 3 years old, but can affect older kids too. Some children are more prone to developing croup when they get a viral upper respiratory infection. Most, though not all, cases of viral croup are mild.


Since Omicron focuses more on the upper airway than the lower, it seems reasonable that there would be more problems in the upper airway - such as coup


Fish Oil and Vitamin D Supplementations in Pregnancy Protect Against Childhood Croup - Jan 2023

The J. of Allergy and Clinical Immunology: In Practice Vol 11, Issue 1, Jan 2023, Pages 315-321 https://doi.org/10.1016/j.jaip.2022.09.027

icklas Brustad MD, PhD a ∗, Luo Yang MSc a ∗, Bo L. Chawes MD, PhD, DMSc a, Jakob Stokholm MD, PhD a b, Gözde Gürdeniz MSc, PhD a, Klaus Bønnelykke MD, PhD a †, Hans Bisgaard MD, DMSc a †

Background
Croup is a prevalent respiratory disorder in early childhood most often caused by parainfluenza virus infections. There are no preventive strategies; therefore, we investigated the potential effects of prenatal micronutrient supplementations.

Objective
To investigate the supplementation effects of (1) 2.4-g n-3 long-chained polyunsaturated fatty acid (n-3 LCPUFA) (fish oil) versus olive oil and (2) high-dose (2800 IU/d) versus standard-dose (400 IU/d) of vitamin D from pregnancy week 24 until 1 week after birth on the risk for offspring croup during the double-blinded first 3 years of life in a secondary analysis of a 2 × 2 factorial designed randomized controlled trial.

Methods
The study was completed in the Danish population-based single-center Copenhagen Prospective Studies on Asthma in Childhood 2010 mother–child cohort, which included 736 pregnant women. Croup was diagnosed by physicians’ clinical examinations and medical record checks. Potential mediating mechanisms were investigated using blood metabolomics, airway cytokines, and airway microbiome.

Results
Of 695 children, 97 had croup before age 3 years (14%). The risk of croup was reduced in the

  • n-3 LCPUFA (ncases / ntotal = 38/346; 11%) versus olive oil group (59 of 349 children; 17%) (hazard ratio = 0.62; 95% CI, 0.41-0.93; P = .02) and in the
  • high-dose vitamin D group (32 of 295 children; 11%) versus the standard-dose group (51 of 286 children; 18%) (hazard ratio = 0.60; 95% CI, 0.38-0.93; P = .02).

There was no evidence of interaction or additive effects between the supplements (Pinteraction = .56). Furthermore, the results did not change when they were adjusted for each other, persistent wheeze, and lower respiratory tract infection.

Conclusions
This analysis of the double-blinded period of the Copenhagen Prospective Studies on Asthma in Childhood 2010 randomized controlled trial of n-3 LCPUFA and high-dose vitamin D supplementation during pregnancy demonstrated a reduced risk of croup in early childhood.

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