Objective: To investigate the incidence of post-bronchiolitis recurrent wheezing and the risk factors.Methods: Infants with bronchiolitis were enrolled from November 2016 through March 2017. 24 healthy children were enrolled as the control group. Nasopharyngeal aspirates were obtained for detecting respiratory virus including by using RT-PCR and direct immunofluorescent assay. The serum levels of cytokine including TSLP, IL2, IL13, TIMP-1, MMP-9, IL33, IL5, IL4, IL25, TNF- α and MIP-1α were measured by using flow cytometry. The patients were followed every 3 months for a duration of 2 years by telephone or outpatient.Results: 1. 89 infants were enrolled, of which 81 patients were successfully followed up. 2. 22.2% of the patients experienced recurrent wheezing episodes. 3. The proportion of eczema, systemic glucocorticoid treatment and patients with moderate to severe condition were significantly higher in recurrent wheezing group than in non-recurrent wheezing group (52.4% vs 83.3%; 36.5% vs 66.7%; 33.3% vs 61.1%, respectively, both P<0.05); The serum level of TNF- α was lower in recurrent wheezing group (P< 0.05) ;The serum levels of IL-4、IL-5、IL-25、IL-33 were significantly higher among patients without recurrent wheezing (P< 0.05). 4. Logistic regression analysis showed that eczema was an independent risk factor for post-bronchiolitis recurrent wheezing (OR=7.488; 95% CI, 1.447-38.759; P=0.016). Conclusion: The prevalence of recurrent wheezing among infants after bronchiolitis was 22.2% in 2-year follow-up. Eczema is the only independent risk factor and no correlation was found between the specific virus and disease severity with post-bronchiolitis recurrent wheezing.This work was supported by the National Natural Science Foundation of China, No.81573167; Jiangsu Science and Technology Department, No. BE2017657; Science and Technology Project of Suzhou, No. SYSD2017092; No. LCZX201809
Background: Infants with bronchiolitis have an increased risk of developing recurrent wheezing and asthma. However, the association between bronchiolitis and recurrent wheezing remains controversial.Objective: To investigate the incidence of post-bronchiolitis recurrent wheezing and associated risk factors.Methods: Infants with bronchiolitis were enrolled from November 2016 through March 2017. We also enrolled 24 healthy children with no history of wheezing from the department of children's health prevention as a control group. Nasopharyngeal aspirates were obtained for detection of respiratory viruses which were analyzed by reverse transcriptase polymerase chain reaction (RT-PCR) and direct immunofluorescent assay. Serum cytokines including TSLP, IL2, IL13, TIMP-1, MMP-9, IL33, IL5, IL4, IL25, TNF- α and MIP-1α were measured by flow cytometry. Patients were followed every 3 months for a duration of 2 years by telephone or at outpatient appointments.Results: We enrolled 89 infants, of which 81 patients were successfully followed up. In total, 22.2% of patients experienced recurrent wheezing episodes. The proportion of patients with eczema, systemic glucocorticoid use and patients with moderate-to-severe disease were significantly higher in the recurrent wheezing group than the non-recurrent wheezing group (83.3% vs 52.4%; 66.7% vs 36.5%; 61.1% vs 33.3%, respectively, all P<0.05); The serum level of TNF‑ α was lower in the recurrent wheezing group (P<0.05), and the serum levels of IL-4, IL-5, IL-25, IL-33 were significantly higher among patients without recurrent wheezing (P<0.05). Logistic regression analysis showed that eczema was an independent risk factor for post-bronchiolitis recurrent wheezing (odds ratio [OR]=7.488; 95% confidence interval [CI], 1.447–38.759; P=0.016). Conclusion: The incidence of recurrent wheezing among infants after contracting bronchiolitis was 22.2% during a 2-year follow-up. Eczema was the only independent risk factor identified and no correlation was found between the specific virus and disease severity in children with post-bronchiolitis recurrent wheezing.
Background The coronavirus disease 2019 (COVID-19) pandemic has led to the use of multifaceted non-pharmaceutical interventions (NPIs) to mitigate disease spread. NPIs also have an impact on the prevalence of non-SARS-CoV-2 viruses. We aimed to explore the prevalence of common respiratory viruses among hospitalized children with lower respiratory tract infections (LRTIs) in Suzhou, southeast China, during the COVID-19 pandemic. Methods Medical records and nasopharyngeal specimens of children hospitalized with LRTIs in the Children's Hospital of Soochow University from 2018 to 2021 were collected. Seven common respiratory viruses, namely, respiratory syncytial virus (RSV), adenovirus (ADV), influenza virus types A and B (IV-A and IV-B), parainfluenza virus types 1, 2, and 3 (PIV l to 3), were detected by direct immunofluorescence. Fluorescent quantitative PCR was performed to detect Bocavirus (HBoV), and reverse transcription-polymerase chain reaction (RT‒PCR) was performed to detect human respiratory rhinovirus (HRV) and human metapneumovirus (HMPV). Results A total of 13873 children including 8429 (60.8%) patients in 2018-2019 and 5444(39.2%) patients in 2020-2021 were enrolled. The total detection rate of respiratory viruses was 40.2% in 2018-2019 and 39.9% in 2020-2021. There was a high prevalence of HRV in June-September 2020 (after the reopening of schools), which was higher than the prevalence observed in June-September in 2018 and 2019. The detection rate of RSV decreased sharply in February 2020. After the schools were fully reopened in September 2020, the number of RSV cases gradually increased and peaked in December 2020 and January 2021.From July-September 2021, there was an unexpected mini-peak of RSV. The prevalence of IV decreased significantly after the COVID-19 epidemic, especially IV-A, but there were no significant changes in the age of infection and the epidemic season. HBoV, HMPV, PIV1~3, and ADV showed different degrees of changes in the detection rate and season of infection before and after the COVID-19 epidemic. Conclusions During the COVID-19 pandemic, the detection rates of common respiratory viruses in Suzhou, southeast China, have changed differently with strict NPIs. Understanding the changes in the detection of respiratory pathogens after the epidemic will help clinicians develop early coping strategies. Key words: COVID-19, children, respiratory viruses, NPIs, viral interference
Background: Infants with bronchiolitis have an increased risk of developing recurrent wheezing and asthma. However, the risk factors for the development of recurrent wheezing after bronchiolitis remains controversial.Objective: To investigate the incidence of post-bronchiolitis recurrent wheezing and associated risk factors.Methods: Infants with bronchiolitis were enrolled from November 2016 through March 2017. Nasopharyngeal aspirates were obtained for detection of respiratory viruses which were analyzed by reverse transcriptase polymerase chain reaction (RT-PCR) and direct immunofluorescent assay. Serum cytokines including TSLP, IL2, IL13, TIMP-1, MMP-9, IL33, IL5, IL4, IL25, TNF- α and MIP-1α were measured by flow cytometry. Patients were followed every 3 months for a duration of 2 years by telephone or at outpatient appointments.Results: We enrolled 89 infants, of which 81 patients were successfully followed up. In total, 22.2% of patients experienced recurrent wheezing episodes. The proportion of patients with history of eczema, systemic glucocorticoid use and patients with moderate-to-severe disease were significantly higher in the recurrent wheezing group than the non-recurrent wheezing group (83.3% vs 52.4%; 66.7% vs 36.5%; 61.1% vs 33.3%, respectively, all P<0.05); There were no significant differences between patients with and without recurrent wheezing episodes in the levels of TSLP, IL2, IL13, TIMP-1, MMP-9, IL33, IL5, IL4, IL25, TNF- α and MIP-1α (P>0.05). Logistic regression analysis showed that history of eczema was an independent risk factor for post-bronchiolitis recurrent wheezing (odds ratio [OR]=5.622; 95% confidence interval [CI], 1.3–24.9; P=0.023).Conclusion: The incidence of recurrent wheezing among infants after contracting bronchiolitis was 22.2% during a 2-year follow-up. History of eczema was the only independent risk factor identified and no correlation was found between the specific virus and disease severity in children with post-bronchiolitis recurrent wheezing.
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