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Acute Upper Airway Disease Up in Children During Omicron Surge

Roughly one in five children hospitalized with SARS-CoV-2 and upper airway infection had severe disease

WEDNESDAY, April 20, 2022 (HealthDay News) — Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive rates of acute pediatric upper airway infection (UAI) increased during the omicron surge, according to a research letter published online April 15 in JAMA Pediatrics.

Blake Martin, M.D., from University of Colorado in Aurora, and colleagues used data from the U.S. National COVID Cohort Collaborative to assess whether cases of UAI among children increased when omicron became the dominant SARS-CoV-2 variant in the United States. The analysis included children (younger than 19 years) with a positive SARS-CoV-2 test result in both the pre-omicron (March 1, 2020, to Dec. 25, 2021) and omicron (Dec. 26, 2021, to Feb.17, 2022) periods.

The researchers found that SARS-CoV-2-positive UAI rates increased with progression from the pre-omicron to omicron periods (1.5 versus 4.1 percent), with 46 percent of the 384 cases occurring during the omicron period. During this period, children with UAIs were more likely to be younger and Hispanic or Latino and less likely to receive dexamethasone or develop severe disease versus those in the pre-omicron period. More than one in five children hospitalized with SARS-CoV-2 and UAI developed severe disease. The proportion of children with a pediatric complex chronic condition was similar between the two periods.

“While the rate of SARS-CoV-2 pediatric UAI is not overwhelmingly high, understanding this new clinical phenotype and the potential for acute upper airway obstruction may help guide therapeutic decision making,” the authors write.

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