Increased risk of wheeze and decreased lung function after respiratory syncytial virus infection.
BACKGROUND
A relationship between hospitalization for respiratory syncytial virus (RSV) bronchiolitis and asthma development has been suggested in case-control studies.


OBJECTIVE
The aim of this study was to assess the risk of current wheeze, asthma, and lung function at school age in infants previously hospitalized for RSV bronchiolitis compared to non-hospitalized children.


METHODS
For this study, data from a prospective birth cohort of unselected, term-born infants (n = 553), of whom 4 (0.7%) were hospitalized for RSV bronchiolitis, and a prospective patient cohort of 155 term infants hospitalized for RSV bronchiolitis were used. Respiratory outcomes at age 6 in children hospitalized for RSV bronchiolitis were compared to non-hospitalized children.


RESULTS
The risk of current wheeze was higher in hospitalized patients (n = 159) compared to non-hospitalized children (n = 549) (adjusted odds ratio (OR) 3.2 (95% CI 1.2-8.1). Similarly, the risk of current asthma, defined as a doctor's diagnosis of asthma plus current symptoms or medication use, was higher in hospitalized patients (adjusted OR 3.1 (95% CI 1.3-7.5). Compared to non-hospitalized children, RSV bronchiolitis hospitalization was associated with lower lung function (mean difference FEV1% predicted -6.8 l (95% CI (-10.2 to -3.4).


CONCLUSIONS
This is the first study showing that hospitalization for RSV bronchiolitis during infancy is associated with increased risk of wheezing, current asthma, and impaired lung function as compared to an unselected birth cohort at age 6.
Department of Paediatric Pulmonology and Allergology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands.
Kim
K
Zomer-Kooijker
Department of Paediatric Pulmonology and Allergology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands.
Cornelis K
CK
van der Ent
Department of Psychiatry, University Medical Centre Utrecht, Utrecht, The Netherlands.
Marieke J J
MJ
Ermers
Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands.
Cuno S P M
CS
Uiterwaal
Department of Epidemiology, Biostatistics & HTA and operating rooms, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands.
Maroeska M
MM
Rovers
Department of Paediatric Immunology and Infectious Diseases, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands.
Louis J
LJ
Bont
D001249:Asthma / Q000209:etiology / Q000503:physiopathology*; D001990:Bronchiolitis, Viral / Q000209:etiology / Q000503:physiopathology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D054884:Host-Pathogen Interactions; D006801:Humans; D016015:Logistic Models; D008168:Lung / Q000503:physiopathology / Q000821:virology; D008297:Male; D011446:Prospective Studies; D012129:Respiratory Function Tests; D012135:Respiratory Sounds / Q000209:etiology / Q000503:physiopathology*; D018357:Respiratory Syncytial Virus Infections / Q000150:complications / Q000503:physiopathology* / Q000821:virology; D018113:Respiratory Syncytial Virus, Human / Q000502:physiology; D012307:Risk Factors