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Analysis of Multimorbidity of Moderate to Severe Allergic Rhinitis in Children: A Real-World Study
Zheng Gu1, Ping Wei2, Wei Kou2
1Department of Otolaryngology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing Key Laboratory of Child Infection and Immunity, Chongqing, China, 403730416@qq.com.
Insights
Allergic rhinitis in children often presents with other conditions. Key risk factors for these multimorbidities include family allergy history, young age, and cesarean birth.
Area of Science:
- Pediatrics
- Allergology
- Epidemiology
Background:
- Allergic rhinitis (AR) in children frequently co-occurs with other health issues, complicating management.
- Limited research exists on multimorbidities in Chinese children with AR.
Purpose of the Study:
- To determine the prevalence of multimorbidities in Chinese children with moderate to severe AR.
- To identify factors influencing these multimorbidities.
Main Methods:
- Prospective enrollment of 600 children diagnosed with moderate-severe AR.
- Data collection via questionnaires, allergen testing, and nasopharyngoscopy.
- Investigated comorbidities: atopic dermatitis, asthma, allergic conjunctivitis, etc.
Main Results:
- High prevalence of recurrent epistaxis (46.5%), allergic conjunctivitis (46.3%), and atopic dermatitis (40.7%).
- Risk factors identified: younger age (<6 years), family allergy history, cesarean section, and specific allergen sensitivities (dust mites).
- Familial history of allergy, younger age, cesarean section, and allergen type were independent risk factors for various comorbidities.
Conclusions:
- AR in children is associated with numerous allergic and non-allergic comorbidities.
- Age, family history of allergy, allergen type, and mode of delivery are significant risk factors for AR multimorbidities.
Introduction:
Allergic rhinitis (AR) in children is associated with various comorbidities, posing challenges for treatment and management. There have been few investigations of these multimorbidities in Chinese children with AR. Here, we investigated the prevalence of multimorbidities in children with moderate to severe AR and analyzed the influencing factors using real-world data.
Methods:
In total, 600 children who visited the outpatient clinic of our hospital and were diagnosed with moderate-severe AR were prospectively enrolled. All children underwent allergen detection and electronic nasopharyngoscopy. Parents or guardians completed a questionnaire that included age, sex, mode of delivery, feeding pattern, and familial history of allergy. The multimorbidities investigated included atopic dermatitis (AD), asthma, allergic conjunctivitis (AC), chronic rhinosinusitis (CRS), adenoid hypertrophy (AH), tonsil hypertrophy (TH), recurrent epistaxis, and recurrent respiratory tract infections (RRTIs).
Results:
The AR multimorbidities reported in children were as follows: recurrent epistaxis (46.5%), AC (46.3%), AD (40.7%), asthma (22.5%), RRIs (21.3%), CRS (20.5%), AH (19.7%), and TH (12.5%). In univariate logistic regression analysis, age (<6 years), birth mode, familial history of allergy, and single dust mite allergy were associated with AR multimorbidity (p < 0.05). Multivariate logistic regression revealed that a familial history of allergy was an independent risk factor for AC (odds ratio [OR] = 1.539, 95% confidence interval [CI]: 1.104-2.145) and AH (OR = 1.506, 95% CI: 1.000-2.267) (p < 0.05). Age (<6 years) was independently associated with the risk of AD (OR = 1.405, 95% CI: 1.003-1.969) and RRTIs (OR = 1.869, 95% CI: 1.250-2.793) (p < 0.05), cesarean section with AR and CRS risk (OR = 1.678, 95% CI: 1.100-2.561), and single dust mite allergy with asthma (OR = 1.590, 95% CI: 1.040-2.432) and CRS (OR = 1.600, 95% CI: 1.018-2.515) risk (p < 0.05). Further, non-dust mite allergy was independently associated with AR and CRS (OR = 2.056, 95% CI: 1.084-3.899).
Conclusion:
AR was found to be accompanied by different comorbidities, including both allergic and non-allergic comorbidities, complicating disease treatment. These findings demonstrated that age (<6 years), familial history of allergy, types of allergens, and cesarean section were risk factors for different multimorbidities associated with AR.
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