The Rate of Pediatric Stridor in the Emergency Department

Objective:  Stridor is a clinical manifestation that arises from the narrowing of the airway. Recent research has demonstrated that COVID 19 infection, especially with the Omicron variant, can lead to more severe presentations of stridor such as severe croup. Furthermore, croup and recurrent croup have been associated with asthma. The purpose of this study is to assess the effect of COVID-19 and the pandemic on stridor related presentation and development of asthma/RAD.

Methods: This study employed a retrospective chart review of Jim Pattison Children Hospital and Royal University Hospital emergency department visits (ED) during the period of March 2018 to March 2022.  March 2018 - March 2020 would be considered pre-pandemic and onwards will be considered post-pandemic. Stridor related presentations to ED visits were assessed for rates of stridor visits, severity and current or later asthma diagnosis.

Results/Conclusion: The COVID-19 pandemic caused a decrease in stridor-related presentations due to masking protocols causing decreased spread of respiratory viruses. Stridor related presentation during the first year of the pandemic or the delta wave was associated with higher risk of current or later asthma/RAD diagnosis. There were no differences in severity measures (admission, inhaled bronchodilator use, and CTAS). COVID-19 related croup only and rarely occurred in the Omicron wave.