Allergy Asthma Respir Dis.  2019 Apr;7(2):78-85. 10.4168/aard.2019.7.2.78.

Seasonal patterns and etiologies of croup in children during the period 2010–2015: A multicenter retrospective study

• Lee YJ
• Kim HB
• Kim BS
• Kim CK
• Kim CH
• Kim HY
• Kim S
• Kim Y
• Park C
• Seo JH
• Sol IS
• Sung M
• Song MS
• Song DJ
• Ahn YM
• Oh HL
• Yu J
• Lee KS
• Lee E
• Lee JS
• Jang GC
• Jang YY
• Chung EH
• Chung HL
• Choi SM
• Choi YJ
• Han MY
• Yang HJ
• Shim JY
• Kim JT
• The Pneumonia & Respiratory Disease Study Group of Korean Academy of Pediatric Allergy and Respiratory Disease

• KMID: 2444840
• DOI: http://doi.org/10.4168/aard.2019.7.2.78

Abstract

PURPOSE
Croup is known to have epidemics in seasonal and biennial trends, and to be strongly associated with epidemics of parainfluenza virus. However, seasonal and annual epidemics of croup have not been clearly reported in Korea. This study aimed to examine the seasonal/annual patterns and etiologies of childhood croup in Korea during a consecutive 6-year period.
METHODS
Pediatric croup data were collected from 23 centers in Korea from 1 January 2010 to 31 December 2015. Electronic medical records, including multiplex reverse transcription polymerase chain reaction (RT-PCR) results, demographics and clinical information were cross-sectionally reviewed and analyzed.
RESULTS
Overall, 2,598 childhood croup patients requiring hospitalization were identified during the study period. Among them, a total of 927 who underwent RT-PCR were included in the analysis. Males (61.5%) predominated, and most (63.0%) of them were younger than 2 years of age (median, 19 months; interquartile range, 11-31 months). Peak hospitalization occurred in 2010 and 2012 in even-numbered years, and parainfluenza virus (PIV, 39.7%) was the most common cause of childhood croup requiring hospitalization, followed by respiratory syncytial virus (14.9%), human rhinovirus (12.5%), Mycoplasma pneumonaie (10.6%), and human coronavirus (7.3%).
CONCLUSION
It is concluded that croup hospitalization has a biennial pattern in even-numbered years. PIV may be the most common cause of childhood croup; however, croup epidemics could be attributed to other viruses.

Keyword

Child; Croup; Hospitalization; Retrospective studies; Seasons

MeSH Terms

Child*
Coronavirus
Croup*
Demography
Electronic Health Records
Hospitalization
Humans
Korea
Male
Mycoplasma
Paramyxoviridae Infections
Polymerase Chain Reaction
Respiratory Syncytial Viruses
Retrospective Studies*
Reverse Transcription
Rhinovirus
Seasons*

Figure

• 

  Fig. 1. Pathogens detected in hospitalized children with croup between 2010 and 2015. A total of 927 children with croup were hospitalized between 1 January 2010 through 31 December 2015. Among them, most prevalent age group was <2 years old (n=584, 63.0%). Most commonly detected pathogen was parainfluenza virus under the age of 4 years. MP, Mycoplasma pneumoniae; AdV, adenovirus; RV, human rhinovirus; Flu, influenza virus; PIV, parainfluenza virus; HMPV, human metapneumovirus; RSV, respiratory syncytial virus; BoV, bocavirus; CoV, coronavirus.

• 

  Fig. 2. Numbers of hospitalized children with croup and pathogen-detected croup between 1 January 2010 through 31 December 2015, according to month and year. A total of 2,598 hospitalized children with croup were identified. Among them respiratory pathogens were detected in 927 children.

• 

  Fig. 3. Distribution of pathogen-detected croup between 1 January 2010 and 31 December 2015, according to month and year. (A) Pathogens detected in hospitalized children with croup. (B) Distribution of PIV, and PIV subtypes. (C) Distribution of CoV and CoV subtypes. AdV, adenovirus; HRV, human rhinovirus; Flu, influenza virus; PIV, parainfluenza virus; HMPV, human metapneumovirus; RSV, respiratory syncytial virus; BoV, bocavirus; HCoV, human coronavirus.

Reference

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