Rhinovirus Infection in Children with Acute Bronchiolitis and Its Impact on Recurrent Wheezing and Asthma Development

Biagi, Carlotta; Rocca, Alessandro; Poletti, Giulia; Fabi, Marianna; Lanari, Marcello

doi:10.3390/microorganisms8101620

Cited by 22 publications

(21 citation statements)

References 53 publications

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“…19,20 Since the first observation on the link from rhinovirus-induced wheezing in infancy to emergence of childhood asthma in 2003, 13 the role of rhinoviruses in bronchiolitis, early-childhood wheezing and subsequent asthma has been well documented. 8,21,22 In a large American post-bronchiolitis cohort, rhinovirus increased later asthma risk only with presence of concomitant atopic sensitization. 23 In the present study, rhinovirus findings in early childhood were not anymore significant risk factors of adulthood asthma, although such association was seen in the earlier phases of the follow-up.…”

Section: Ta B L Ementioning

confidence: 99%

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

et al. 2021

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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

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Section: Ta B L Ementioning

confidence: 99%

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

et al. 2021

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“…This virus shows a complex circulation pattern, as numerous genotypes/subgroups within each group have been identified and co-circulation of genotypes within the same community is common [7,8]. Other viruses, such as rhinovirus, adenovirus, influenza, parainfluenza, metapneumovirus, and human coronavirus, are less frequently implicated [9,10]. Up to 30% of hospitalized infants with bronchiolitis have multiple respiratory virus co-infections [11].…”

Section: Introductionmentioning

confidence: 99%

Impact of Guidelines Publication on Acute Bronchiolitis Management: 10-Year Experience from a Tertiary Care Center in Italy

et al. 2021

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Bronchiolitis is the most common lower respiratory tract infection in infants. According to evidence-based guidelines, diagnosis is clinical, there is no need for routine use of laboratory or instrumental tests and therapy is primarily supportive, based on oxygen and adequate fluid supplementation. Nevertheless, unnecessary diagnostic tests and pharmacological treatments are still very common. The aim of this retrospective cohort study was to evaluate how the management of bronchiolitis has changed in the last ten years in a Tertiary Care Center in Italy, assessing adherence to national guidelines. Considering the publication of the Italian inter-society consensus document in 2014, we compared patients admitted in the prior four epidemic seasons with patients admitted in the latter six epidemic seasons. The comparison between the two groups showed a significant reduction in the prescription of systemic corticosteroids (58.9% vs. 41.8%, p < 0.001), nebulized epinephrine (73.8% vs. 38.3%, p < 0.001) and antibiotics (59.5% vs. 42.3%, p < 0.001), together with a drastic decrease in the use of chest X-ray (92.2% vs. 54.4%, p < 0.001). On the contrary, the use of inhaled salbutamol remained substantially stable over time (39.4% vs. 37.6%, p = 0.505). Despite the encouraging results, further efforts are needed to limit the prescription of ineffective therapies like antibiotics and inhaled salbutamol.

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“…Beside the allergen aspects as triggering factors for exacerbation, viruses play a major role in seasonal exacerbations, e.g., in winter [ 17 , 55 , 77 , 84 , 85 , 86 , 87 ]. An infection with HRV or RSV may be associated with life-threatening events and affect disease development and progression [ 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 ]. Interestingly, in our cohort, HRV and RSV were the most prevalent viruses, which were detected in the nasopharyngeal swab specimens obtained during an exacerbation.…”

Section: Discussionmentioning

confidence: 99%

Viral Infection and Respiratory Exacerbation in Children: Results from a Local German Pediatric Exacerbation Cohort

Sallard

Schult

Baehren

et al. 2022

Viruses

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Respiratory viruses play an important role in asthma exacerbation, and early exposure can be involved in recurrent bronchitis and the development of asthma. The exact mechanism is not fully clarified, and pathogen-to-host interaction studies are warranted to identify biomarkers of exacerbation in the early phase. Only a limited number of international exacerbation cohorts were studied. Here, we have established a local pediatric exacerbation study in Germany consisting of children with asthma or chronic, recurrent bronchitis and analyzed the viriome within the nasopharyngeal swab specimens derived from the entire cohort (n = 141). Interestingly, 41% of exacerbated children had a positive test result for human rhinovirus (HRV)/human enterovirus (HEV), and 14% were positive for respiratory syncytial virus (RSV). HRV was particularly prevalent in asthmatics (56%), wheezers (50%), and atopic (66%) patients. Lymphocytes were decreased in asthmatics and in HRV-infected subjects, and patients allergic to house dust mites were more susceptible to HRV infection. Our study thus confirms HRV infection as a strong ‘biomarker’ of exacerbated asthma. Further longitudinal studies will show the clinical progress of those children with a history of an RSV or HRV infection. Vaccination strategies and novel treatment guidelines against HRV are urgently needed to protect those high-risk children from a serious course of disease.

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Rhinovirus Infection in Children with Acute Bronchiolitis and Its Impact on Recurrent Wheezing and Asthma Development

Cited by 22 publications

References 53 publications

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

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

Impact of Guidelines Publication on Acute Bronchiolitis Management: 10-Year Experience from a Tertiary Care Center in Italy

Viral Infection and Respiratory Exacerbation in Children: Results from a Local German Pediatric Exacerbation Cohort

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