The impact of viral respiratory infection on the severity and recovery from an asthma exacerbation

Chang, Anne B., Clark, Ron, Acworth, Jason P., Petsky, Helen L., & Sloots, Theo P. (2009) The impact of viral respiratory infection on the severity and recovery from an asthma exacerbation. Pediatric Infectious Disease Journal, 28(4), pp. 290-294.

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Abstract

Background

Viral respiratory illness triggers asthma exacerbations, but the influence of respiratory illness on the acute severity and recovery of childhood asthma is unknown. Our objective was to evaluate the impact of a concurrent acute respiratory illness (based on a clinical definition and PCR detection of a panel of respiratory viruses, Mycoplasma pneumoniae and Chlamydia pneumoniae) on the severity and resolution of symptoms in children with a nonhospitalized exacerbation of asthma.

Methods

Subjects were children aged 2 to 15 years presenting to an emergency department for an acute asthma exacerbation and not hospitalized. Acute respiratory illness (ARI) was clinically defined. Nasopharyngeal aspirates (NPA) were examined for respiratory viruses, Chlamydia and Mycoplasma using PCR. The primary outcome was quality of life (QOL) on presentation, day 7 and day 14. Secondary outcomes were acute asthma severity score, asthma diary, and cough diary scores on days 5, 7,10, and 14.

Results

On multivariate regression, presence of ARI was statistically but not clinically significantly associated with QOL score on presentation (B = 0.36, P = 0.025). By day 7 and 14, there was no difference between groups. Asthma diary score was significantly higher in children with ARI (B = 0.41, P = 0.039) on day 5 but not on presentation or subsequent days. Respiratory viruses were detected in 54% of the 78 NPAs obtained. There was no difference in the any of the asthma outcomes of children grouped by positive or negative NPA.

Conclusions

The presence of a viral respiratory illness has a modest influence on asthma severity, and does not influence recovery from a nonhospitalized asthma exacerbation.

Impact and interest:

19 citations in Scopus
18 citations in Web of Science®
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ID Code: 71259
Item Type: Journal Article
Refereed: Yes
Keywords: asthma, viral infections, acute exacerbation, polymerase chain reaction
DOI: 10.1097/INF.0b013e31819067b1
ISSN: 0891-3668
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > PAEDIATRICS AND REPRODUCTIVE MEDICINE (111400) > Paediatrics (111403)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Public Health & Social Work
Deposited On: 28 Aug 2014 23:09
Last Modified: 29 Jan 2015 00:25

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