An increased asthma risk continued until young adulthood after early‐childhood hospitalisation for wheezing

Abstract

The risk of asthma has been increased in children who have presented with wheezing during lower respiratory infection in early childhood in many follow-up studies, and this increased asthma risk seems to continue beyond puberty. 1 Four prospective cohort studies consisting of patients hospitalised for infection-associated wheezing in early childhood were started in Finland and Sweden in the 1980s and 1990s, and in these cohorts, outcomes have been published until 16-20 years of age. [2][3][4][5] At that age, doctordiagnosed (or allergy-related) asthma was present in 30% of cases in three studies, 2,4,5 compared to 1%-5% of controls. 4,5

Is age during bronchiolitis the most important predictor of post‐bronchiolitis outcome?

“…Three of these research groups have published the results on clinical outcomes assessed at 24–29 years of age. 4 Doctor‐diagnosed asthma was present in 31%–37% of cases in two studies and in 10% of cases in one study, compared with 5%–11% of controls, respectively. Self‐reported symptom‐based asthma was present in 35%–36% of cases, compared with 11%–15% of controls.…”

“…Follow‐ups of the post‐bronchiolitis cohorts have continued beyond puberty, as summarised recently in this journal. 4 In adolescence, doctor‐diagnosed (or allergy‐related) asthma was present in 30% of cases in three studies, compared to 1%–5% of controls. Self‐reported (or symptom‐based) asthma was present in 39%–64% of cases, compared to 9%–15% of controls.…”

“…Within the cohort, self‐reported asthma was more common after wheezing induced by rhinoviruses than after wheezing induced by RSV at the median ages of 7.2 years (70.0% vs. 10.0%) 1 and at the median age of 18.5 years (64.3% vs. 42.9%). 4 …”

Asthma and Lung Function in Adulthood After Early-Childhood Wheezing

“…The risk of asthma has been increased in children who have presented with wheezing during lower respiratory tract infection in early childhood, and this increased asthma risk has continued beyond puberty 1,2 . Three prospective cohort studies consisting of patients hospitalized for infectionassociated wheezing at <24 months of age, which started in Finland and Sweden in the 1980`s and 1990`s, have reported clinical and lung function outcomes until >25 years of age [3][4][5][6][7] . These are the only thus far published cohorts consisting of earlychildhood wheezers followed prospectively from the wheezing episode until adulthood.…”

“…Initially, these studies were not controlled, and the risks of asthma and reduced lung function, as well as the predictive factors, were assessed by analyses within the cohorts. Matched populationbased controls without wheezing or hospitalization histories at <24 months of age were recruited for the adulthood follow-ups of the studies [3][4][5][6][7] . One of the cohorts comprised only questionnaire data 7 , which means that lung function measurements were not available and new asthma diagnoses could not be done by the researchers.…”