Abstract
Numerous preventive strategies against respiratory syncytial virus (RSV) are undergoing late stage evaluation in humans and, in addition to their intended benefit for acute illness, may impact long term consequences of infection in infants. Severe RSV infection has been repeatedly associated in the literature with long term complications, including impaired lung function, recurrent wheezing, and asthma. However, whether RSV lower respiratory tract infection (LRTI) causally affects the odds for developing wheezing and/or asthma during childhood requires further study, and the biological mechanisms underlying this hypothetical progression from viral illness to chronic lung disease are poorly characterized. In this review, we summarize the literature exploring the association between RSV LRTI in infancy and subsequent recurrent wheezing and pediatric asthma.
Highlights
Respiratory syncytial virus (RSV) is the leading cause of lower respiratory tract infection (LRTI) in infants and young children, causing an estimated 33 million LRTIs, 3.2 to 3.4 million hospitalizations, and 66,000 to 199,000 deaths in children under five years of age, every year, worldwide [1,2]
Severe RSV infection has been repeatedly associated in the literature with long term complications, including impaired lung function, recurrent wheezing, and asthma [5,6]
We summarize the literature exploring the association between RSV LRTI in infancy and subsequent recurrent wheezing and pediatric asthma
Summary
Respiratory syncytial virus (RSV) is the leading cause of lower respiratory tract infection (LRTI) in infants and young children, causing an estimated 33 million LRTIs, 3.2 to 3.4 million hospitalizations, and 66,000 to 199,000 deaths in children under five years of age, every year, worldwide [1,2]. Severe RSV infection has been repeatedly associated in the literature with long term complications, including impaired lung function, recurrent wheezing, and asthma [5,6]. 50% of children diagnosed with asthma have previously experienced a viral LRTI requiring a healthcare visit [19,22] These observations suggest that for a causal link between both entities to exist, it requires a combination of genetic, environmental, and/or other factors besides the viral infection. The recent understanding of asthma not as a disease with a single mechanism of illness but as a syndrome [23,24], reformulates our interpretation of causality previously ascribed to RSV, demanding a recategorization of the specific relationship between “RSV bronchiolitis” and the several different “asthmas” experienced during childhood [25]. We summarize the literature exploring the association between RSV LRTI in infancy and subsequent recurrent wheezing and pediatric asthma
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