News Scan for Apr 15, 2022

Upper airway infections in kids with COVID-19 rose with Omicron surgeRates of upper airway infections (UAIs) such as croup and bacterial tracheitis among pediatric COVID-19 patients, though low, rose after the Omicron variant became dominant in December 2021, with more than one fifth of hospitalized children with both conditions developing severe illness, estimates a study today in JAMA Pediatrics.The University of Colorado–led US National COVID Cohort Collaborative analyzed its data and those from a National Institutes of Health–funded pediatric COVID-19 dashboard on 18,849 hospitalized COVID-19 patients 18 years and younger from Mar 1, 2020, to Dec 25, 2021 (before the emergence of Omicron) and after (Dec 26, 2021, to Feb 17, 2022).Of the 18,849 children, 384 (2.0%) had UAIs, and 81 (21%) required invasive ventilation, the use of vasopressor drugs to raise blood pressure, or extracorporeal membrane oxygenation or died.

Rates of UAIs in COVID-positive children rose from 1.5% to 4.1% after the emergence of Omicron, with 178 of 384 cases (46%) diagnosed during that time.Pediatric patients with UAIs during Omicron were more likely than those diagnosed in the preceding Delta period to be younger and Hispanic and less likely to be given the corticosteroid dexamethasone or to become severely ill.

The proportion of children with a complex chronic condition weren't significantly different during the two periods, at 36% (74 of 206) before Omicron and 22% (39 of 178) after.While noncoronaviruses such as parainfluenza and respiratory syncytial virus most often cause UAI, coronaviruses are also commonly implicated, the study authors said. "Young children are especially vulnerable to UAI given their small and relatively collapsible