By Erika Edwards and Laura Strickler

COVID-19’s omicron variant appears to be affecting children under age 5 in a new way: a harsh, barking cough known as croup.

While croup generally is not harmful, it can be frightening for parents already on edge about their babies and toddlers, too young for the COVID-19 vaccine, becoming infected with the virus.

Doctors say this is most likely occurring because it appears omicron tends to settle higher up in the respiratory tract, rather than deeper in the lungs.

“Little kids’ airways are so narrow that it takes far less inflammation to clog them,” said Dr. Buddy Creech, a pediatric infectious disease expert and director of the Vanderbilt Vaccine Research Program at the Vanderbilt University Medical Center in Nashville, Tennessee.

When a child with tiny, inflamed airways breathes, it makes a distinctive noise, and can result in a cough that sounds like a dog or a seal.

Creech said that he and his colleagues have noted “croup-like presentations” in young children who test positive for COVID-19. The upper part of kids’ airways become very swollen. “When that happens,” he said, “there’s that characteristic barking cough.”

A number of seasonal viruses, including parainfluenza and respiratory syncytial virus, can lead to croup and an infection of the respiratory tract called bronchiolitis. Now it seems, COVID-19 — specifically the omicron variant — should be added to that list.

Dr. Saif Al Qatarneh, a pediatric pulmonologist at West Virginia University, said that he, too, has noted an increase in such diagnoses in tandem with a rise in pediatric COVID cases.

So far, the omicron variant appears to be less severe than the delta variant, Dr. Anthony Fauci said Wednesday during a White House COVID-19 Response Team briefing. 

“But remember the caveat: Rapid community spread is seeing larger numbers of children being hospitalized — again, mostly among the unvaccinated,” said Fauci, the president’s chief medical adviser.

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