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Published on: January 21, 2018
Clinical correlates of rhinovirus infection in preschool asthma
Tuomas Jartti1, Unna Liimatainen1, Paraskevi Xepapadaki2
1Department of Pediatrics and Adolescent Medicine, Turku University Hospital and University of Turku, Turku, Finland.
Insights
Rhinovirus (RV) infections worsen preschool asthma symptoms and outcomes. Vitamin D supplementation may reduce RV infections, suggesting it could help manage unstable childhood asthma.
Area of Science:
- Pediatric Allergy and Immunology
- Respiratory Medicine
- Infectious Diseases
Background:
- Preschool asthma is a significant health concern, with many children not outgrowing it.
- Limited data exists on the impact of rhinovirus (RV) infections in preschool asthmatic children.
- Understanding RV's role is crucial for effective management strategies.
Purpose of the Study:
- To investigate the role of RV infections in preschool asthma.
- To identify susceptibility factors associated with RV infection.
- To analyze the clinical course and medium-term outcomes of RV infections in this population.
Main Methods:
- Prospective follow-up of 130 asthmatic children (aged 4-6 years) for 12 months.
- Collection of allergy data and health questionnaires at baseline.
- Detection of respiratory viruses, including RV, in nasopharyngeal washes during illness and scheduled visits.
Main Results:
- Rhinovirus (RV) was detected in 39% of all visits.
- Vitamin D supplementation showed an inverse association with RV infection.
- RV infection correlated with more severe acute illness (coughing, sleep issues, runny nose) and worse 12-month outcomes (awakenings, exercise symptoms).
Conclusions:
- Vitamin D supplementation may possess an anti-rhinovirus effect.
- RV infection serves as a key clinical indicator of unstable preschool asthma.
- These findings highlight RV's significant impact on preschool asthma severity and duration.
Background:
Investigation of preschool asthma is important since not all children outgrow their illness during this age. Data are scarce on the role of rhinovirus (RV) infections in this patient group.
Objectives:
To investigate the role of RV infections in preschool asthma: (i) susceptibility factors, (ii) clinical course, and (iii) medium-term outcome.
Methods:
A total of 130 asthmatic children aged 4-6 years from the multinational PreDicta cohort were prospectively followed for a 12-month period. Allergy tests and a standard health questionnaire were carried out at study entry. Respiratory virus presence in nasopharyngeal washes was studied at illness visits and at 3 scheduled visits.
Results:
At study entry, mean age of the children was 5.3 years. Of 571 visits, 54% were positive for any virus and 39% for RV. Patient characteristics were only assessed with RV infection due to low number of other viruses. The use of supplementary vitamin D was inversely associated with RV infection (P < .05). RV infection was associated with more severe course of acute illness in terms of more severe nighttime coughing, more sleep disturbances, and more days with runny nose (all P < .05). RV infection was also associated with more severe disease course during the 12-month follow-up in terms of more nights with awakenings and more days of exercise-related symptoms (both P < .05).
Conclusions:
Vitamin D supplementation may have an anti-rhinovirus effect. Both short- and medium-term outcomes suggest RV infection to be an important clinical marker of instable preschool asthma.
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