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The Association Between Respiratory Viruses and Asthma Exacerbation in Children Visiting Pediatric Emergency
Won Seok Lee1, Joo Young Song1, Jeewon Shin1
1Department of Pediatrics, CHA Ilsan Medical Center, CHA University College of Medicine, Goyang 10414, Republic of Korea.
Insights
Respiratory viral infections significantly impact childhood asthma exacerbations. Rhinovirus was linked to increased respiratory distress and steroid use, while adenovirus required oxygen supplementation, guiding clinical management.
Area of Science:
- Pediatric Pulmonology
- Infectious Diseases
- Asthma Research
Background:
- Respiratory viral infections are a primary trigger for asthma exacerbations in children.
- Limited studies explore the specific associations between viruses, symptoms, treatments, and outcomes in pediatric asthma emergencies.
Purpose of the Study:
- To investigate the relationship between respiratory viral infections and clinical presentation, treatment, and hospital admission in children with asthma exacerbations.
- To identify specific viruses associated with particular symptoms and interventions in pediatric asthma emergencies.
Main Methods:
- A study of 395 children under 15 with diagnosed asthma experiencing exacerbations.
- Respiratory virus polymerase chain reaction (PCR) performed on 96 patients.
- Analysis of symptoms (dyspnea, tachypnea, chest retraction, wheezing, GI symptoms), treatments (oxygen, systemic steroids), symptom relief, and hospital admission.
Main Results:
- Respiratory viruses detected in 75% of tested patients, with 21.9% having multiple infections.
- Rhinovirus identified in 61.5% of positive cases, associated with tachypnea, chest retraction, and systemic steroid use.
- Adenovirus linked to increased need for oxygen supplementation.
Conclusions:
- Rhinovirus infection in children with asthma exacerbations correlates with increased respiratory distress and need for systemic steroids.
- Adenovirus infection is associated with the requirement for nasal cannula oxygen supplementation.
- Findings aid clinicians in better symptom assessment, targeted treatment selection, and improved outcomes for pediatric asthma exacerbations.
Abstract:
Background/Objectives: Respiratory viral infections are a major cause of asthma exacerbations. However, studies examining the association between symptoms, signs, treatments, outcomes of asthma exacerbations, and various respiratory viruses in children are limited. This study aims to investigate the association between respiratory viral infections and clinical symptoms and signs, treatment, and hospital admission in children with asthma exacerbations visiting the pediatric emergency department. Methods: This study examined 395 children under 15 years of age who had a previous diagnosis of bronchial asthma, experienced asthma exacerbation, and visited an emergency center between 1 July 2015 and 30 June 2017. Among the 395 participants, respiratory virus polymerase chain reaction (PCR) was conducted in 96 patients (24.3%). The symptoms and signs of asthma exacerbation (dyspnea, tachypnea, chest retraction, wheezing, and gastrointestinal symptoms), treatment (oxygen supplementation and systemic steroid administration), symptom relief within 1 h, and hospital admission were analyzed. Results: Among the 96 patients who underwent respiratory virus PCR, at least one respiratory virus was detected in 72 (75.0%), and over two viruses were detected in 21 children (21.9%). Three common viruses were detected: rhinovirus in 59 (61.5%), adenovirus in 10 (10.4%), and respiratory syncytial virus (RSV) in nine children (9.4%). Rhinovirus infection was associated with tachypnea (adjusted odd ratio (aOR) 4.457, p = 0.007), chest retraction (aOR 3.142, p = 0.013), and systemic steroid administration (aOR 3.065, p = 0.034). Adenovirus infection was associated with oxygen supplementation via nasal cannula (aOR 5.297, p = 0.042). Conclusions: Rhinovirus was associated with tachypnea, chest retraction, and systemic steroid administration, while adenovirus was linked to oxygen supplementation in childhood asthma exacerbations. These findings will help clinicians to better observe asthma symptoms, select appropriate treatments, and improve outcomes for asthma exacerbations.
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