Clinical and Laboratory ObservationUnderestimation of Influenza Viral Infection in Childhood Asthma Exacerbations
Section snippets
Methods
This prospective study included children of 1.5 to 15.0 years of age examined for acute asthma in the emergency department of a Paris hospital from November through March during 4 successive winters (2005 to 2009) with the same design as previously reported studies.6, 7 All children with symptoms considered to be severe (marked expiratory wheezing despite 3 inhalations of β2-adrenergic aerosols in 1 hour or transcutaneous oxygen saturation <95% for >3 hours) were hospitalized. Other children
Results
During the winter months (Nov 1-Mar 31) from 2005 to 2009, 369 children >18 months of age previously diagnosed as having asthma were referred to the emergency department of our hospital for acute wheezing. Nasopharyngeal aspirates or a precise clinical history were absent in 30 patients, so only 339 patients were included in the study (55% males), 232 hospitalized (mean age, 44.7 months; range, 21-107 months) and 107 discharged home (mean age, 38 months; range, 18-84 months). None of these
Discussion
One-third of children with asthma require immediate therapy for acute complications per year, and >50% of the annual costs for childhood asthma relate to hospitalizations or emergency care. Viral infections are more often associated with asthma exacerbations in young children than in adults, but the respective roles of the different respiratory viruses in acute exacerbations remain disputed. The relative importance of influenza vaccination in children with asthma has been debated. Most
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Cited by (19)
Prevalence of viral respiratory infections amongst asthmatics: Results of a meta-regression analysis
2020, Respiratory MedicineEpidemiology and risk factors for asthma
2019, Respiratory MedicineCitation Excerpt :Influenza has also been associated with exacerbation of ongoing disease [54]. In one series, influenza A virus was detected in 2.6% of hospitalized children and 14.1% (P < .001) of ambulatory-treated patients with asthma flares [55]. HRV triggered wheeze appears to confer particular predilection for future atopic asthma comparable with the risk associated with allergen sensitization when followed up at ages 7 and 13 in the Childhood Origins of Asthma (COAST) study [56].
Understanding the unique characteristics of seasonal influenza illness to improve vaccine uptake in the US
2018, VaccineCitation Excerpt :Young children, older adults, pregnant women, and people with chronic comorbid conditions are more likely to experience influenza-related complications, hospitalization and death [2–9]. In addition, influenza can worsen pre-existing chronic health problems; for example, increases in asthma attacks, chronic obstructive pulmonary disease exacerbations, myocardial infarction and stroke have been observed during influenza illness [10–13]. However, even healthy people can contract influenza and suffer serious health consequences at any age [2].
IgE cross-linking impairs monocyte antiviral responses and inhibits influenza-driven T <inf>H</inf> 1 differentiation
2017, Journal of Allergy and Clinical ImmunologyAsthma: The Interplay Between Viral Infections and Allergic Diseases
2015, Immunology and Allergy Clinics of North AmericaCitation Excerpt :The seasonality of RV-associated asthma exacerbations has been well described,17 and multiple studies have shown a close temporal relationship between respiratory viral infection and disease exacerbation.18–21 Rhinoviruses are most commonly isolated during asthma exacerbations, but other viruses, including human metapneumovirus22 and influenza,18,21 represent important contributors. During the 2009 influenza pandemic, an increase in disease severity and exacerbations was noted in pediatric asthmatic patients, with a disproportionate number requiring intensive care.23
Exacerbation of asthma and airway infection: Is the virus the villain?
2014, Jornal de PediatriaCitation Excerpt :A 36.0% rate of viral detection was obtained, but no difference was observed regarding the viral profile between inpatients and outpatients. The most frequently observed viruses were RSV (15.0%) and Bocavirus (12.0%), but hRV was not included in the viral panel of this study.20 A group of 179 Australian children aged up to 16 years had their nasal secretions collected in three periods between 2000 and 2002, and were compared with a control group of non-asthmatic children with upper respiratory tract infection (URTI) in the same period and another group of 28 children with controlled asthma, assessed during routine consultations.
The authors declare no conflicts of interest.