Background: Our aim was to evaluate the association between viral findings during bronchiolitis and the use of asthma controller medication (primary outcome) and systemic corticosteroids (secondary outcome) during the first post-bronchiolitis year.
Methods: We enrolled 408 children hospitalized for bronchiolitis at <24 months of age in a prospective, 3-center, 1-year follow-up study in Finland. Viruses were detected with polymerase chain reaction in nasopharyngeal aspirates. The parents underwent a structured interview during hospitalization. Twelve months later, the use of asthma medication was asked in a structured questionnaire. Multivariable logistic regression was used for statistical analysis.
Results: In total, 365 (89%) children completed the 1-year follow-up. The use of long-term asthma controller medication was highest in the rhinovirus-positive group (61% vs. 15% in respiratory syncytial virus-positive group; adjusted odd ratios, 7.5; 95% confidence interval: 3.7–15.3), followed by children negative for both respiratory syncytial virus and rhinovirus (36%; adjusted odd ratios, 2.6; 95% confidence interval: 1.3–5.3). Likewise, rhinovirus etiology was associated with more courses of systemic corticosteroids during the follow-up. The main findings were similar in a subset of infants aged <12 months with first wheezing.
Conclusions: Children hospitalized for rhinovirus-positive bronchiolitis used long-term asthma controller medication more often than those hospitalized for rhinovirus-negative bronchiolitis during first year after hospitalization.
From the *Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland; †Department of Pediatrics, Central Hospital of Central Finland, Jyväskylä, Finland; ‡Department of Pediatrics, Turku University Hospital, Turku, Finland; §Center for Child Health Research, Tampere University and University Hospital, Tampere, Finland; ¶Allergy Centre, Tampere University Hospital, Tampere, Finland; ‖Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; **Department of Molecular Virology and Microbiology and ††Department of Pediatrics, Baylor College of Medicine, Houston, Texas; and ‡‡Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Accepted for publication September 9, 2015.
E.B. received funding from Kerttu and Kalle Viik Foundation (Kuopio, Finland) and received EVO funding. T.J. received funding from the Academy of Finland, the Finnish Medical Foundation, the Sigrid Juselius Foundation and the Foundation for pediatric research (all in Helsinki, Finland). The authors have no other funding or conflicts of interest to disclose.
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Address for correspondence: Eija Bergroth, MD, Department of Pediatrics, Central Hospital of Central Finland, Keskussairaalantie 19, 40620 Jyväskylä, Finland, E-mail: firstname.lastname@example.org.