Recurrent wheezing in children with respiratory syncytial virus (RSV) bronchiolitis in Qatar

Osundwa, V. M.; Dawod, S. T.; Ehlayel, Mohammad

doi:10.1007/bf01957225

Cited by 39 publications

(22 citation statements)

References 15 publications

(7 reference statements)

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“…This was followed by smoking during pregnancy for wheezing and recurrent wheezing, and by male sex for wheezing. In this regard, the present study confirms the result of many others [4][5][6][7][8][9][10][11][12][13]. Likewise, smoking in the family [6,8,9], and in particular smoking during pregnancy [24], were previously identified as risk factors for wheezing.…”

Section: Discussionsupporting

confidence: 91%

“…Acute respiratory failure associated with severe bronchospasm, hypoxia, and carbon dioxide retention necessitate hospitalisation of a fraction of y1-2% of RSV-infected children [3]. A close link between RSVinduced bronchiolitis and development of asthma has been identified in several studies [4][5][6][7][8][9][10][11][12][13][14]. However, there are conflicting results concerning an association between RSV bronchiolitis and allergic sensitisation.…”

mentioning

confidence: 99%

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RSV bronchiolitis and risk of wheeze and allergic sensitisation in the first year of life

Schauer¹,

Hoffjan²,

Bittscheidt³

et al. 2002

Eur Respir J

132

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Severe respiratory syncytial virus (RSV) infection has been hypothesised to be a risk factor for the development of allergy and asthma, but epidemiological studies in older children have been inconclusive. The current study hypothesises that the effect of RSV bronchiolitis might be most prominent during the first year after bronchiolitis.Forty-two infants had experienced RSV bronchiolitis severe enough to cause hospitalisation. For each child with RSV infection, two controls were acquired from a birth cohort and matched for date of birth and sex. All the children were followed prospectively and underwent a follow-up examination at a mean age of 1 yr, which included physical examination, and serum immunoglobulin (Ig) E tests for common food and inhaled allergens.Risk factors for the development of recurrent wheezing and IgE antibodies were analysed for the whole group of 126 children. A positive test for IgE antibodies was noted in 14 of 42 (33%) RSV children and in 2 of 84 (2.3%) children in the control group. RSV bronchiolitis was the most important risk factor for allergic sensitisation. Likewise, 13 children (15.5%) of the RSV group and three (3.6%) children of the control group suffered from recurrent wheezing, and RSV bronchiolitis posed a considerable risk for recurrent wheezing.Severe respiratory syncytial virus bronchiolitis during the first year of life is an important risk factor for the development of recurrent wheezing and sensitisation to common allergens during the subsequent year. Eur Respir J 2002; 20: 1277-1283 In infants and toddlers under the age of 2 yrs, the virus most frequently isolated during wheezing episodes is respiratory syncytial virus (RSV) [1,2]. Acute respiratory failure associated with severe bronchospasm, hypoxia, and carbon dioxide retention necessitate hospitalisation of a fraction of y1-2% of RSV-infected children [3]. A close link between RSVinduced bronchiolitis and development of asthma has been identified in several studies [4][5][6][7][8][9][10][11][12][13][14]. However, there are conflicting results concerning an association between RSV bronchiolitis and allergic sensitisation. While some studies found bronchiolitis a considerable high-risk factor for allergic sensitisation [6,8], others did not [11-13, 15, 16]. The reason for this apparent contradiction is not clear. Differently recruited control groups, a difference in assessment of atopy and a different severity of RSV-induced illness in the index group [7] were discussed as explanations for conflicting results. In most studies, children were assessed at the age of 8-12 yrs. It might be possible that different rates of sensitisation at an earlier time point may be missed. Interestingly, there are two studies assessing the same cohort at 1 yr [6] or 5.5 yrs [8] of age for the first time, and at 7 [7] or 10 [9] yrs of age, respectively, for a second time.Whereas in both studies the first assessment revealed a higher number of allergic sensitisations in the index compared with the control group, at the second ...

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Section: Discussionsupporting

confidence: 91%

mentioning

confidence: 99%

RSV bronchiolitis and risk of wheeze and allergic sensitisation in the first year of life

Schauer¹,

Hoffjan²,

Bittscheidt³

et al. 2002

Eur Respir J

132

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“…51,54,60 During 24 months of follow-up, Osundwa et al found that this outcome was significantly higher in RSV-infected children than in controls (44% versus 13%), and that a family history of atopia did not increase the child's susceptibility. 54 Weber's study, with a 19 -33 month follow-up period, showed a higher incidence of wheezing in children with RSV, with a relative risk (RR) of 7.33, and a progressive reduction of the differences between cases and controls with increasing follow-up time. 60 Finally, Fjaerli observed a higher proportion of wheezing diagnosed in children with RSV infection than in controls (48% versus 14%), although there were no differences between RSV bronchiolitis and that caused by other viruses.…”

Section: Resultsmentioning

confidence: 99%

“…51 With regard to methodologic quality, Osundwa's work had important methodologic flaws such as incorrect statistical analysis and failure to adjust for confounding factors, which could represent confounding bias in the interpretation of the results. 54 Weber's study was a prospective follow-up of 3 cohorts (a) children hospitalized with RSV infection (cases); (b) children with no history of hospital admission due to RSV during the epidemic period (control 1); and (c) children born after the epidemic period (control 2). This study has important methodologic limitations, with both major flaws (definition of diagnostic criteria, RSV not excluded in the control group, lack of baseline measures of prognostic factors, and failure to adjust for confounding factors) and minor flaws (incomplete description of inclusion criteria and incorrect analysis of losses to follow-up), which limit the validity of the results.…”

Section: Resultsmentioning

confidence: 99%

The Association Between Respiratory Syncytial Virus Infection and the Development of Childhood Asthma

Pérez-Yarza

Moreno²,

Lázaro³

et al. 2007

Pediatric Infectious Disease Journal

106

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On the basis of this systematic review of the literature, it can be concluded that a significant association exists between RSV infection in childhood and the long-term development of subsequent episodes of recurrent wheezing or asthma. However, the methodologic quality of the articles evaluated is limited, and hence additional studies are needed, ideally, with specific therapeutic interventions aimed at reducing RSV replication.

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“…After RSV-infection associated lower respiratory tract illness (including bronchiolitis and/or pneumonia) requiring hospitalization in infancy, the later occurrence of recurrent wheezing has been 40-44% in toddlers and preschoolers [25][26][27]141,143,[149][150][151] and the prevalence of school-age asthma 5-28% [141,143,150,151].…”

Section: Long-term Outcome Of Early Childhood Wheezing Requiring Hospmentioning

confidence: 99%

Respiratory Viruses, Eosinophil Activation, and Early Allergen Sensitization - Early Life Predictors of Persistent Wheezing and Asthma

Kotaniemi‐Syrjänen¹,

Korppi

2007

CPR

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Approximately 20% of all children will suffer from wheezing illnesses, and in 1-3% of all infants, respiratory distress is severe enough to require hospitalization. As wheezing infants form a heterogeneous group with different phenotypes and outcomes, it is still a challenge to identify those who will go on wheezing to develop asthma. In order to facilitate the prediction of later asthma, algorithms have been developed for clinical use. The algorithms validated this far are based on personal atopic findings and the parental history of asthma, and blood eosinophilia has been the only laboratory marker included. In this review, we will focus on the role of respiratory viruses, eosinophil activation markers, specific immunoglobulin E antibodies, and skin prick tests, as early life predictors of persistent wheezing and asthma.According to recently published results, rhinoviral infection seems to carry a high risk for persistence of wheezing. Sensitization to inhalant allergens in infancy strongly increases the risk for later respiratory allergy. Eosinophil activation markers seem not to offer significant additional value over blood eosinophils.Determination of viral etiology of wheeze, and/or screening for early sensitization to inhalant allergens in individuals with no clinically evident atopy might be of use in identifying future asthmatics.

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Recurrent wheezing in children with respiratory syncytial virus (RSV) bronchiolitis in Qatar

Cited by 39 publications

References 15 publications

RSV bronchiolitis and risk of wheeze and allergic sensitisation in the first year of life

RSV bronchiolitis and risk of wheeze and allergic sensitisation in the first year of life

The Association Between Respiratory Syncytial Virus Infection and the Development of Childhood Asthma

Respiratory Viruses, Eosinophil Activation, and Early Allergen Sensitization - Early Life Predictors of Persistent Wheezing and Asthma

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