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Clinical and epidemiologic factors related to subsequent wheezing after virus-induced lower respiratory tract infections in hospitalized pediatric patients younger than 3 years

European Journal of Pediatrics volume 173, pages 959–966 (2014)Cite this article

Abstract

Most wheezing episodes in infants are caused and exacerbated by virus-induced lower respiratory tract infections. However, there are few reports of epidemiologic and clinical virus-specific research with a focus on virus-induced wheezing. The purpose of the current study was to characterize the clinical presentation of virus-induced wheezing in pediatric patients <3 years of age who were hospitalized with lower respiratory tract infections. Of the 412 patients in the study, 216 were followed for 3 years. Nasopharyngeal aspirates collected from the patients at the time of admission were examined for the presence of respiratory syncytial virus (RSV), rhinovirus (RV), parainfluenza-3 virus (PIV-3), human metapneumovirus (hMPV), and influenza virus (Flu) using reverse-transcription polymerase chain reaction and rapid diagnostic tests. Clinical signs were assessed using a severity scoring system. In patients with wheezing at the time of admission, RSV, RV, RSV+RV, Flu, PIV-3, and hMPV were detected in 33, 14, 8, 8, 5, and 3 % of samples, respectively. There were no differences in age and severity scores between patients harboring more prevalent viruses (RSV and RV) and those with less common infections. Patients with wheezing and RV-positive aspirates at the time of admission were more likely to develop subsequent wheezing during the following 3 years. Conclusion: RSV and RV infections are factors in the development and exacerbation of wheezing after virus-induced lower respiratory tract infections. Moreover, RV-induced wheezing may be associated with subsequent recurrent wheezing and the development of asthma.

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Acknowledgments

We thank Honzumi K and Tanji M for their technical support. We also thank the staff of the pediatric unit of the Soma General Hospital for their assistance with sample collection.

Conflicts of interest and source of funding

This work was supported in part by the Japan Society for the Promotion of Science.

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Authors and Affiliations

  1. Department of Pediatrics, Soma General Hospital, 142 Tubogasaku-Niinuma, Soma City, Fukushima, 976-0011, Japan

    Aya Takeyama, Yoichi Tomita, Ryo Maeda, Masaki Ito & Masahiko Katayose

  2. Department of Pediatrics, School of Medicine, Fukushima Medical University, Fukushima, Japan

    Aya Takeyama, Koichi Hashimoto, Masatoki Sato, Toshiko Sato, Yukihiko Kawasaki & Mitsuaki Hosoya

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  1. Aya Takeyama
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  2. Koichi Hashimoto
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Correspondence to Aya Takeyama.

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Communicated by Willem Proesmans

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Takeyama, A., Hashimoto, K., Sato, M. et al. Clinical and epidemiologic factors related to subsequent wheezing after virus-induced lower respiratory tract infections in hospitalized pediatric patients younger than 3 years. Eur J Pediatr 173, 959–966 (2014). https://doi.org/10.1007/s00431-014-2277-7

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  • DOI: https://doi.org/10.1007/s00431-014-2277-7

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