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. and Sloots, Theo P. (2009) The impact of viral respiratory infection on the severity and recovery from an asthma exacerbation.. The Pediatric Infectious Disease Journal, 28 4: 290-294. doi:10.1097/INF.0b013e31819067b1


Author Chang, Anne B.
Clark, Ron
Acworth, Jason P.
Petsky, Helen L.
Sloots, Theo P.
Title The impact of viral respiratory infection on the severity and recovery from an asthma exacerbation.
Journal name The Pediatric Infectious Disease Journal   Check publisher's open access policy
ISSN 0891-3668
Publication date 2009-04
Year available 2009
Sub-type Article (original research)
DOI 10.1097/INF.0b013e31819067b1
Volume 28
Issue 4
Start page 290
End page 294
Total pages 5
Editor Dr John D Nelson
Place of publication USA
Publisher Lippincott Williams & Wilkins
Collection year 2010
Language eng
Subject C1
920115 Respiratory System and Diseases (incl. Asthma)
920109 Infectious Diseases
060502 Infectious Agents
060506 Virology
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 (8 = 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 (8 = 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.
Formatted 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.


Keyword respiratory infection
Asthma
asthma exacerbations
Q-Index Code C1
Q-Index Status Confirmed Code

 
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Created: Wed, 10 Mar 2010, 09:15:27 EST by Lesley Arnicar on behalf of Clinical Medical Virology Centre