Wheezing Rhinovirus Illnesses During Early Childhood and the Subsequent Development of Asthma

Abstract

RationaleThe contribution of specific viral respiratory wheezing illnesses in infancy and early childhood to the subsequent development of asthma by age 6 years has not clearly been established.Methods259 children were followed prospectively from birth to 6 years in the COAST (Childhood Origins of ASThma) study. The etiology and timing of specific wheezing viral respiratory illnesses during early childhood was assessed comprehensively using nasal lavage, culture and RT-PCR. The developmental relationships of both wheezing illnesses and allergic sensitization in early childhood and asthma at age 6 years were analyzed.ResultsRhinovirus (RV) wheezing (OR = 2.8 95% CI 1.4 5.6) and allergic sensitization (OR = 3.6 95% CI 1.7 7.7) in the first year of life were independently and similarly associated with increased risk of asthma at 6 years of age. By the third year of life, RV wheezing (OR = 25.6 95% CI 8.2 79.6) had a stronger association with asthma at age 6 years than allergic sensitization (OR = 3.4 95% CI 1.7 6.9). Nearly 90% (26 of 30) of children who wheezed with RV in year 3 had asthma at 6 years of age, regardless of the presence or absence of allergic sensitization.ConclusionRV wheezing illnesses and allergic sensitization in early childhood are both independent and additive risk factors for the development of asthma at 6 years of age. RationaleThe contribution of specific viral respiratory wheezing illnesses in infancy and early childhood to the subsequent development of asthma by age 6 years has not clearly been established. The contribution of specific viral respiratory wheezing illnesses in infancy and early childhood to the subsequent development of asthma by age 6 years has not clearly been established. Methods259 children were followed prospectively from birth to 6 years in the COAST (Childhood Origins of ASThma) study. The etiology and timing of specific wheezing viral respiratory illnesses during early childhood was assessed comprehensively using nasal lavage, culture and RT-PCR. The developmental relationships of both wheezing illnesses and allergic sensitization in early childhood and asthma at age 6 years were analyzed. 259 children were followed prospectively from birth to 6 years in the COAST (Childhood Origins of ASThma) study. The etiology and timing of specific wheezing viral respiratory illnesses during early childhood was assessed comprehensively using nasal lavage, culture and RT-PCR. The developmental relationships of both wheezing illnesses and allergic sensitization in early childhood and asthma at age 6 years were analyzed. ResultsRhinovirus (RV) wheezing (OR = 2.8 95% CI 1.4 5.6) and allergic sensitization (OR = 3.6 95% CI 1.7 7.7) in the first year of life were independently and similarly associated with increased risk of asthma at 6 years of age. By the third year of life, RV wheezing (OR = 25.6 95% CI 8.2 79.6) had a stronger association with asthma at age 6 years than allergic sensitization (OR = 3.4 95% CI 1.7 6.9). Nearly 90% (26 of 30) of children who wheezed with RV in year 3 had asthma at 6 years of age, regardless of the presence or absence of allergic sensitization. Rhinovirus (RV) wheezing (OR = 2.8 95% CI 1.4 5.6) and allergic sensitization (OR = 3.6 95% CI 1.7 7.7) in the first year of life were independently and similarly associated with increased risk of asthma at 6 years of age. By the third year of life, RV wheezing (OR = 25.6 95% CI 8.2 79.6) had a stronger association with asthma at age 6 years than allergic sensitization (OR = 3.4 95% CI 1.7 6.9). Nearly 90% (26 of 30) of children who wheezed with RV in year 3 had asthma at 6 years of age, regardless of the presence or absence of allergic sensitization. ConclusionRV wheezing illnesses and allergic sensitization in early childhood are both independent and additive risk factors for the development of asthma at 6 years of age. RV wheezing illnesses and allergic sensitization in early childhood are both independent and additive risk factors for the development of asthma at 6 years of age.