Assessment of Wheezing Frequency and Viral Etiology on Childhood and Adolescent Asthma Risk

Abstract

We have previously reported that early rhinovirus (RV) wheezing illnesses are the most robust predictor of asthma development at age 6 years in high-risk children in the Childhood Origins of ASThma (COAST) birth cohort study. We sought to assess the role of etiology and frequency of wheezing illnesses in asthma risk from ages 6 to 13 years. A total of 259 children were followed prospectively to age 6 years, and 217 were followed to age 13 years. A generalized additive logistic regression model (GAM) of asthma was fit for asthma diagnosed at ages 6, 8, 11, 13 years; with smooth terms for number of RV wheezing illnesses, number of non-RV wheezing illnesses, and their interaction. In the absence of significant interaction the main effect p-values are reported. The number of RV wheezing episodes in early childhood was significantly associated with asthma at all ages (6 years: p<0.0001; 8 years: p<0.0001; 11 years: p=0.0006; 13 years: p=0.002). The number of non-RV wheezing episodes was not significantly associated with asthma (6 years: p=0.06; 8 years: p=0.09; 11 years: p=0.06; 13 years: p=0.33). RV wheezing illnesses remain an important predictor of asthma development in high-risk children and continued research efforts should focus on defining host and viral factors that promote wheezing RV illnesses in early childhood.