The Relationship between the Time of First Respiratory Syncytial Virus Bronchiolitis and Later Wheezing and Asthma Development

Ri ra Kim; Mee yong Shin

doi:10.7581/pard.2012.22.1.54

Journal List > Pediatr Allergy Respir Dis > v.22(1) > 1033210

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Kim and Shin: The Relationship between the Time of First Respiratory Syncytial Virus Bronchiolitis and Later Wheezing and Asthma Development

Original Article

Pediatric Allergy and Respiratory Disease

Pediatric Allergy and Respiratory Disease 2012; 22(1): 54-63.

Published online: 31 March 2012

DOI: https://doi.org/10.7581/pard.2012.22.1.54

The Relationship between the Time of First Respiratory Syncytial Virus Bronchiolitis and Later Wheezing and Asthma Development

Ri ra Kim, MD, Mee yong Shin, MD

Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea.

Corresponding author (smy0218@schmc.ac.kr)

Received 14 September 2011 Revised 1 October 2011 Accepted 6 October 2011

Abstract

Purpose

Respiratory syncytial virus(RSV) bronchiolitis is believed to be associated with later development of asthma and wheezing. This study was conducted to determine the relationship between the age of the first RSV bronchiolitis episode, the development of later wheezing and asthma, and the related other factors.

Methods

We studied 255 infants admitted with their first episode of RSV bronchiolitis. Epidemiological and clinical data were collected retrospectively from medical records and through telephone interviews. The patients were divided into ≤3 months, 4 to 12 months, and 13 to 24 months.

Results

Eighty-one infants were ≤3 months, 115 were 4 to 12 months, and 59 were 13 to 24 months old. The gender ratios (Male:Female) were 1:1, 1.6:1, and 3.2:1. Familial and personal history of allergic diseases and disease severity did not significantly differ according to the age of the first RSV bronchiolitis episode. The occurrence of wheezing was associated with the presence of a familial and personal history of allergic diseases, but not with gender (male) or disease severity. The risk for asthma increased when the infants had their first RSV bronchiolitis episode at an older age. A personal history of allergic diseases was associated with an increased risk for asthma.

Conclusion

Asthma was more frequently diagnosed in older infants. The most important risk factors for recurrent wheezing and asthma were a familial and personal history of allergic diseases. Therefore, it was thought that RSV bronchiolitis is not the cause of recurrent wheezing and asthma, but that infants with a genetic predisposition to asthma have an increased risk for RSV bronchiolitis.

Keywords: Respiratory syncytial virus, Bronchiolitis, Asthma, Wheezing

Figures and Tables

Fig. 1

Sex distribution according to the age groups.

Table 1

Clinical Scoring System Using Initial Symptom Severity

Table 2

Demographic Features of Study Population

Values are presented as number (%) or mean±SD.

Table 3

Clinical Data after First RSV Bronchiolitis according to the Age Groups

Values are presented as number (%) or mean±SD.

AD, atopic dermatitis; FA, food allergy; AR, allergic rhinitis; BA, bronchial asthma; URI, upper respiratory infection.

Table 4

Wheezing within 2 Years and the Correlating Factors

Values are presented as number (%) or mean±SD.

AD, atopic dermatitis; FA, food allergy; AR, allergic rhinitis; BA, bronchial asthma.

Table 5

Asthma Diagnosis within 2 Years after First RSV Bronchiolitis and the Correlating Factors

OR, odds ratio; aOR, adjusted odds ratio; CI, confidence interval.

^*aOR is adjusted by age, sex, allergic disease history, allergic family history, atopic dermatitis, initial symptom severity, systemic steroid treatment.

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