The Calculated Risk of Childhood Asthma From Severe Bronchiolitis

Gaffin, Jonathan M.; Phipatanakul, Wanda

doi:10.1016/j.jaip.2016.10.015

Cited by 8 publications

(6 citation statements)

References 15 publications

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“…This finding is interesting in that the cumulative evidence suggested that bronchiolitis in early life is a major risk factor of asthma, given the lack of information on the association between a history of bronchiolitis and asthma severity 3536. Diverse factors, such as severity of bronchiolitis, sex, and viruses, can affect the association between a history of bronchiolitis in infancy and asthma in later life,37383940 through interactions between antiviral and atopic inflammatory pathways 3541. Since we did not evaluate causative respiratory viruses, frequency of bronchiolitis, and severity of bronchiolitis in infancy in the present study, we could not identify the associations between diverse factors and development and severity of asthma.…”

Section: Discussionmentioning

confidence: 95%

Associated Factors for Asthma Severity in Korean Children: A Korean Childhood Asthma Study

Lee

Song

Kim

et al. 2020

Allergy Asthma Immunol Res

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PurposeChildhood asthma has a considerable social impact and economic burden, especially in severe asthma. This study aimed to identify the proportion of childhood asthma severity and to evaluate associated factors for greater asthma severity.MethodsThis study was performed on 667 children aged 5–15 years with asthma from the nationwide 19 hospitals in the Korean childhood Asthma Study (KAS). Asthma was classified as mild intermittent, mild persistent, and moderate/severe persistent groups according to the National Asthma Education and Prevention Program recommendations. Multinomial logistic regression models were used to identify the associated factors for greater asthma severity.ResultsMild persistent asthma was most prevalent (39.0%), followed by mild intermittent (37.6%), moderate persistent (22.8%), and severe persistent asthma (0.6%). Onset later than 6 years of age (adjusted odds ratio [aOR], 1.69 for mild persistent asthma; aOR, 1.92 for moderate/severe persistent asthma) tended to increase asthma severity. Exposure to environmental tobacco smoke (aOR, 1.53 for mild persistent asthma; aOR, 1.85 for moderate/severe persistent asthma), and current dog ownership with sensitization to dog dander (aOR, 5.86 for mild persistent asthma; aOR, 6.90 for moderate/severe persistent asthma) showed increasing trends with greater asthma severity. Lower maternal education levels (aOR, 2.32) and no usage of an air purifier in exposure to high levels of outdoor air pollution (aOR, 1.76) were associated with moderate/severe persistent asthma.ConclusionsModification of identified environmental factors associated with greater asthma severity might help better control childhood asthma, thereby reducing the disease burden due to childhood asthma.

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Section: Discussionmentioning

confidence: 95%

Associated Factors for Asthma Severity in Korean Children: A Korean Childhood Asthma Study

Lee

Song

Kim

et al. 2020

Allergy Asthma Immunol Res

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“…[1][2][3] Severe bronchiolitis is also considered a risk factor for future asthma. 4,5 Respiratory syncytial virus (RSV) is the most frequent cause of bronchiolitis, but other viruses, especially rhinovirus (RV), are also detected. 3,6 In follow-up studies, RV-induced bronchiolitis/early wheezing illness has been highly associated Abbreviations used aHR-Adjusted hazard ratio aOR-Adjusted odds ratio HR-Hazard ratio OR-Odds ratio RSV-Respiratory syncytial virus RV-Rhinovirus with the development of asthma.…”

Section: Introductionmentioning

confidence: 99%

Rhinovirus Type in Severe Bronchiolitis and the Development of Asthma

Bergroth

Aakula

Elenius

et al. 2020

The Journal of Allergy and Clinical Immunology: In Practice

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What is already known about this topic? Respiratory syncytial virus (RSV)-and rhinovirus (RV)-induced bronchiolitis are associated with an increased risk of asthma.What does this article add to our knowledge? Compared with children with RSV-induced bronchiolitis, children with RV-Ae or RV-Ceinduced bronchiolitis start asthma control medication earlier and are more likely to use it 4 years later. The risk is especially high among patients with RV-C, atopic dermatitis, and fever.How does this study impact current management guidelines? Secondary prevention strategies targeting rhinoviruses, especially RV-C, might help to prevent childhood asthma.BACKGROUND: Respiratory syncytial virus (RSV)-and rhinovirus (RV)-induced bronchiolitis are associated with an increased risk of asthma, but more detailed information is needed on virus types. OBJECTIVE: To study whether RSV or RV types are differentially associated with the future use of asthma control medication. METHODS: Over 2 consecutive winter seasons (2008-2010), we enrolled 408 children hospitalized for bronchiolitis at age less than 24 months into a prospective, 3-center, 4-year follow-up study in Finland. Virus detection was performed by real-time reverse transcription PCR from nasal wash samples. Four years later, we examined current use of asthma control medication. RESULTS: A total of 349 (86%) children completed the 4-year follow-up. At study entry, the median age was 7.5 months, and 42% had RSV, 29% RV, 2% both RSV and RV, and 27% non-RSV/-RV etiology. The children with RV-A (adjusted hazard ratio, 2.3; P [ .01), RV-C (adjusted hazard ratio, 3.5; P < .001), and non-RSV/-RV (adjusted hazard ratio, 2.0; P [ .004) bronchiolitis started the asthma control medication earlier than did children with RSV bronchiolitis. Four years later, 27% of patients used asthma control medication; both RV-A (adjusted odds ratio, 3.0; P [ .03) and RV-C (adjusted odds ratio, 3.7; P < .001) etiology were associated with the current use of asthma medication. The highest risk was found among patients with RV-C, atopic dermatitis, and fever (adjusted odds ratio, 5.0; P [ .03). CONCLUSIONS: Severe bronchiolitis caused by RV-A and RV-C was associated with earlier initiation and prolonged use of asthma control medication. The risk was especially high when bronchiolitis was associated with RV-C, atopic dermatitis, and fever. Ó

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“…In the context that neither asthma medications nor hypertonic saline is efficacious for acute bronchiolitis, 1 both groups of interventions are also not recommended for post-bronchiolitis chronic cough. However, as current data suggest that the incidence of asthma is increased post-acute viral bronchiolitis, 17 clinicians should assess for the presence of the symptoms and signs of asthma (eg, recurrent wheeze and dyspnea responsive to beta 2 agonists), which is in-line with recommendations in current CHEST chronic cough guidelines. 11 , 15 , 16 …”

Section: Resultsmentioning

confidence: 77%