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The Impact of Viral Respiratory Infection on the Severity and Recovery From an Asthma Exacerbation

Chang, Anne B., Clark, R., Acworth, J. P., Petsky, H. and Sloots, T. (2009). The Impact of Viral Respiratory Infection on the Severity and Recovery From an Asthma Exacerbation. Pediatric Infectious Disease Journal,28(4):290-294.

Document type: Journal Article

IRMA ID 10491xPUB89
Title The Impact of Viral Respiratory Infection on the Severity and Recovery From an Asthma Exacerbation
Author Chang, Anne B.
Clark, R.
Acworth, J. P.
Petsky, H.
Sloots, T.
Journal Name Pediatric Infectious Disease Journal
Publication Date 2009
Volume Number 28
Issue Number 4
ISSN 0891-3668   (check CDU catalogue open catalogue search in new window)
Start Page 290
End Page 294
Total Pages 5
Place of Publication US
Publisher Lippincott Williams & Wilkins
HERDC Category C1 - Journal Article (DEST)
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.
Keywords viral respiratory infection
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Created: Wed, 03 Mar 2010, 17:09:49 CST