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Lung function, allergic sensitization and asthma in school-aged children after viral-coinfection bronchiolitis

Sara Ruiz1,2, Cristina Calvo3,4,5,6,7, Francisco Pozo8

  • 1Pediatrics Department, Severo Ochoa University Hospital. Leganés, Madrid, Spain. sararuizgonzalez@gmail.com.

Scientific Reports
|May 9, 2022
PubMed

Insights

Children hospitalized for bronchiolitis with single human rhinovirus (HRV) infections showed poorer lung function at school-age. Respiratory morbidity was higher in single HRV or HRV coinfections compared to single respiratory syncytial virus (RSV) infections.

Area of Science:

  • Pediatric Pulmonology
  • Infectious Diseases
  • Allergy and Immunology

Background:

  • Bronchiolitis is a common childhood respiratory infection.
  • Viral infections, including human rhinovirus (HRV) and respiratory syncytial virus (RSV), are primary causes of bronchiolitis.
  • Long-term respiratory outcomes after severe bronchiolitis require further investigation.

Purpose of the Study:

  • To compare lung function, allergic sensitization, and asthma prevalence at 7-9 years in children hospitalized for bronchiolitis with viral coinfection versus single viral infection.
  • To identify specific viral infections associated with long-term respiratory morbidity.
  • To assess the relationship between viral etiology of bronchiolitis and subsequent respiratory health.

Main Methods:

  • An observational study included 181 children aged 7-9 years previously hospitalized for bronchiolitis.
  • Data collected included clinical history, spirometry, fraction of exhaled nitric oxide (FeNO), and skin prick tests for aeroallergens.
  • Children were categorized into single viral infections (HRV, RSV) and viral coinfections.

Main Results:

  • Single HRV infections were associated with lower baseline and post-bronchodilator FEV1 (%) and z-score FEV1 compared to coinfections.
  • Single HRV bronchiolitis was an independent risk factor for FEV1 < 80%.
  • While allergic sensitization rates were similar, allergic rhinitis was more frequent in single HRV infections. Asthma prevalence was significantly higher in RSV/HRV coinfections compared to single RSV infections.

Conclusions:

  • Single HRV infections and viral coinfections are associated with increased respiratory morbidity at school-age compared to single RSV infections.
  • Single HRV bronchiolitis is independently linked to reduced lung function in school-aged children.
  • RSV/HRV coinfections present a higher risk for current asthma development post-bronchiolitis.

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