Onset of asthma‐like symptoms in children with lower respiratory tract infections

Song Mao,Li Fang,Wenjing Shi,Min Xu,Liangxia Wu

doi:10.1002/jcla.23227

Abstract

BackgroundAsthma‐like symptoms (ALS) often occur among children with lower respiratory tract infections (LRTIs). We aimed to determine the potential risk factors for ALS onset in LRTIs children.MethodsA total of 102 LRTIs with ALS and 474 without ALS were enrolled. The relative risk (RR) was used to test the influence of the clinical factors on the ALS risk. We compared the differences of birth data, wheezing history, disease severity, inflammatory markers, infectious pathogens, allergic markers, cardiac, liver, and kidney injury markers between LRTIs with and without ALS onset. Receiver operating curve (ROC) analysis was applied to determine the predictive value of various markers in the ALS risk in LRTIs. Multivariate logistic regression analysis was performed to evaluate the association between various clinical and laboratory parameters and ALS onset in LRTIs.ResultsThe RRs of boys/girls ratio and wheezing history for ALS compared with non‐ALS was 1.263 and 2.850, respectively (P = .026, <10−4). There were significant differences of age, WBC, PLT, EOS, and CK between LRTIs with and without ALS onset (P = .004, .041, .006, .049, and .035). ROC analysis showed that significant associations between the parameters of age, WBC, and PLT and ALS risk among LRTIs were observed. Multivariate logistic regression analysis showed that the clinical and laboratory parameters were not independently associated with the risk of ALS onset among LRTIs.ConclusionsLower age, male, inflammation, and allergic state were risk factors for ALS onset in LRTIs. Comprehensive monitoring and evaluation of these factors may be helpful for ALS prevention.

Highlights

Asthma is the most common chronic disease of children.[1]
Male, inflammation, and allergic state were risk factors for Asthma-like symptoms (ALS) onset in lower respiratory tract infections (LRTI)
Multivariate logistic regression analysis showed that no marked associations were observed between age, birthweight, white blood cell (WBC), PLT, c-reactive protein (CRP), PCT, erythrocyte sedimentation rate (ESR), EOS, urine red blood cell (uRBC), blood urea nitrogen (BUN), serum creatinine (Scr), alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), creatine kinase (CK), and creatine kinase isoenzyme (CKMB) and ALS risk among LRTIs (Table 4), which indicated these clinical and laboratory parameters were not independently associated with the risk of ALS onset among LRTIs

Summary

| INTRODUCTION

Asthma is the most common chronic disease of children.[1]. Increased incidence of asthma leads to significant morbidity and mortality. A number of children lack the typical clinical presentations, in the cases aged less than 6 years.[6] These children are difficult to be evaluated, often presenting with wheezing and breathlessness, regarded as asthma-like symptoms (ALS). Many ALS cases were self-limited, a number of children with ALS were prone to develop asthma In this sense, early identification of risk factors for ALS onset in children seems of great clinical implications. To have an in-depth understanding of this issue, we determined to perform a prospective study of the differences of various indexes, including birth data, wheezing history, disease severity, inflammatory markers, infectious pathogens, allergic markers, cardiac, liver, and kidney injury markers between LRTIs with and without ALS onset. The results were defined as positive or negative according to the cut-off value

| MATERIALS AND METHODS

Findings

| DISCUSSION