Risk factors and prognosis of recurrent wheezing in Chinese young children: a prospective cohort study

Abstract

Background Nearly all the investigations into the risk factors for wheezing and asthma were conducted in developed countries with a high prevalence rate of asthma and allergy, but the studies in developing countries are limited. In this study, we aimed to investigate the risk factors for different wheezing phenotypes in Chinese young children and to explore the prognosis of recurrent wheezing. Methods This cohort study contained the recruitment stage and the follow-up stage conducted by phone questionnaire survey. According to the information collected at the follow-up for wheezing episodes and remission age, our cohort was divided into transient wheezing, persistent wheezing and late-onset wheezing. The wheezing symptoms and potential risk factors were compared between these three wheezing groups. Results From the initial 109 participants, 78.0% completed the follow-up survey. The frequency of current wheezing at followup was significantly reduced in all three groups compared to the recruitment stage ( p < 0.01). We observe a trend that the rhinovirus (RV) and respiratory syncytial virus (RSV) infection rates were higher in the persistent wheezing group, and the overall infection rates appear to be the lowest in late-onset wheezing group at recruitment. At follow-up stage, the rates of rhinitis ever and current rhinitis were both higher in the persistent wheezing (63.0%, 50.0%) and late-onset wheezing groups (88.2%, 58.8%), compared to the transient wheezing group (14.3%, 14.3%). The incidence of current wheezing episodes increased cumulatively if the participant had concomitant risk factors of rhinitis ever, aeroallergens sensitization at recruitment, either alone or together with previous RV infection at the time of recruitment. Conclusion While the incidence of wheezing declined overall with age, but in addition to transient wheezers, additional subsets of children manifest persistent wheeze or late onset wheeze, and moreover the risk factors for wheezing display phenotypic variability between these subgroups. Rhinitis ever and aeroallergens sensitization, either alone or together with previous RV infection, were the most significant predictors for persistent wheezing in children in an eastern environment, such as in China.

Recurrent wheezing after bronchiolitis caused by respiratory syncytial virus in children younger than 3 years: A 1-year follow-up study

“…Matricardi et al 21 showed that the incidence of wheezing declines with age. Guo et al 22 found that the number of wheezing episodes decreases significantly during the follow-up stage and that the age at wheezing onset is earlier in those with transient wheezing than in those with persistent wheezing. The respiratory system gradually undergoes development with age, which may be an important reason for the decrease in the number of wheezing episodes.…”

Bronchial obstruction in pre-school children

“…Следует отметить, что течение рецидивирующего бронхообструктивного синдрома в хронологическом аспекте в целом совпадает с возрастной динамикой симптомов бронхиальной астмы: с увеличением возраста ребенка снижается частота приступов при смехе, плаче, воздействии пищевых аллергенов, нарастает при физической нагрузке и аэросенсибилизации [33,34]. Аэросенсибилизация и коморбидный аллергический ринит как самостоятельно, так и в сочетании с риновирусной инфекцией служат наиболее клинически значимыми предикторами рецидивов бронхиальной обструкции [35,36].…”

Home environmental and lifestyle factors associated with asthma, rhinitis and wheeze in children in Beijing, China

“…Allergic rhinitis is common in children with asthma (de Groot et al, 2012;Price, 2010). Concurrent with the increase of childhood asthma in China, allergic rhinitis, and wheeze, a symptom suggestive of asthma, have also been increasing recently among children (Guo et al, 2019). A survey of ten cities in different geographic regions of China found that the prevalence of rhinitis varied from 24.0% to 50.8%, while the prevalence of wheeze varied from 13.9% to 23.7% (Zhang et al, 2013a).…”