Severe bronchiolitis associated with development of asthma irrespective of etiology

Bronchiolitis is the most common cause of respiratory-related hospital admissions in children <2 years of age, which represents a major public health problem worldwide. Multiple viral agents have been identified as causative of bronchiolitis, and respiratory syncytial virus (RSV) is responsible for 60%–80% of cases of bronchiolitis requiring hospitalization.

An association exists between severe respiratory syncytial virus (RSV)–bronchiolitis and a subsequent increased risk of recurrent wheezing (RW) and asthma. However, a causal relationship remains unproven. Using a retrospective population-based cohort study (339 814 children), bronchiolitis during the first 2 years of life (regardless of etiology and severity) was associated with at least a 3-fold increased risk of RW/asthma at 2–4 years and an increased prevalence of asthma at ≥5 years of age. The risk was similar in children with mild bronchiolitis as in those with hospitalized RSV-bronchiolitis and was higher in children with hospitalized non-RSV-bronchiolitis. The rate of RW/asthma was higher when bronchiolitis occurred after the first 6 months of life. Our results seem to support the hypothesis of a shared predisposition to bronchiolitis (irrespective of etiology) and RW/asthma. However, 60% of hospitalized bronchiolitis cases in our setting are due to RSV, which should be paramount in decision-making on imminent RSV prevention strategies.

Reference:

Cintia Muñoz-Quiles and others, Bronchiolitis, Regardless of Its Etiology and Severity, Is Associated With Increased Risk of Asthma: A Population-Based Study, The Journal of Infectious Diseases, 2023; jiad093, https://doi.org/10.1093/infdis/jiad093

Keywords:

severe, RSV-negative, bronchiolitis, strongly, associated, developing, asthma, severe, RSV-positive, bronchiolitis, Cintia Muñoz-Quiles and others, Bronchiolitis, The Journal of Infectious Diseases, RSV, respiratory syncytial virus, asthma / recurrent wheezing, bronchiolitis, laboratory confirmation, retrospective cohort study