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Children with rhinovirus-positive bronchiolitis more likely to use long-term asthma controller medication

Pediatric patients with rhinovirus-positive bronchiolitis were more likely to use asthma controller medication 12 months after hospitalization compared with patients with respiratory syncytial virus, according to data from a prospective follow-up study from Finland.

“Rhinovirus-positive bronchiolitis was associated with both use of controller medication and treatment with systemic corticosteroids in all analyses, including multivariable analyses adjusted for confounding factors such as parental asthma and atopic eczema in the child,” Eija Bergroth, MD, of the department of pediatrics at Kuopio University Hospital in Kuopio, Finland, and colleagues wrote.

Bergroth and colleagues evaluated 408 pediatric patients from the Finnish MARC-30 study who were younger than 24 months when hospitalized in pediatric or intensive care units for bronchiolitis between 2008 and 2010. Eighty-nine percent (n = 365) of the children completed the one-year follow-up.

The researchers found a respiratory virus in 86% of cases; respiratory syncytial virus (RSV) 43%, rhinovirus in 32% and other viruses in 28%.

Parents of the children with asthma were asked detailed questions during hospitalization and then questioned about asthma medication use at 12-month follow up.

Sixty-one percent of rhinovirus-positive children used long-term asthma controller medication compared with 15% of patients in the RSV-positive group (adjusted OR = 7.5; 95% CI, 3.7-15.3), according to the abstract. Researchers also found 36% of children negative for both rhinovirus and RSV used long-term asthma medication (adjusted OR = 2.6; 95% CI, 1.3-5.3).

Patients who received corticosteroids during the initial hospitalization were more likely to later use corticosteroids, with 44% of patients in the rhinovirus-positive group (adjusted OR = 6.83; 95% CI, 2.66-17.52) and 34% of patients negative for rhinovirus and RSV (adjusted OR = 4.28; 95% CI, 1.72-10.66) receiving more corticosteroids than children with RSV-positive bronchiolitis (8%). Bergroth and colleagues noted similar findings among a subset of patients who were younger than 12 months with first wheezing. – by Jeff Craven

Disclosure: Bergroth reports funding from Kerttu and Kalle Viik Foundation and EVO. Please see the full study for all other researchers’ relevant financial disclosures.