Holmdahl Idun, Filiou Anastasia, Stenberg Hammar Katarina, Asarnoj Anna, Borres Magnus P, van Hage Marianne, Hedlin Gunilla, Söderhäll Cilla, Konradsen Jon R
Astrid Lindgren's Children's Hospital, Karolinska University Hospital, 171 64 Stockholm, Sweden.
Department of Women's and Children's Health, Karolinska Institutet, 171 77 Stockholm, Sweden.
Children (Basel). 2021 Jun 8;8(6):488. doi: 10.3390/children8060488.
One third of all toddlers are in need of medical care because of acute wheeze and many of these children have persistent asthma at school age. Our aims were to assess risk factors for and the prevalence of asthma at age 7 in a cohort of children suffering from an acute wheezing episode as toddlers. A total of 113 children, included during an acute wheezing episode (cases), and 54 healthy controls were followed prospectively from early pre-school age to 7 years. The protocol included questionnaires, ACT, FeNO, nasopharyngeal virus samples, blood sampling for cell count, vitamin D levels, and IgE to food and airborne allergens. The prevalence of asthma at age 7 was 70.8% among cases and 1.9% among controls ( < 0.001). Acute wheeze caused by rhinovirus (RV) infection at inclusion was more common among cases with asthma at age 7 compared to cases without asthma ( = 0.011) and this association remained significant following adjustment for infection with other viruses (OR 3.8, 95% CI 1.4-10.5). Cases with asthma at age 7 had been admitted to hospital more often ( = 0.024) and spent more days admitted ( = 0.01) during the year following inclusion compared to cases without asthma. RV infection stands out as the main associated factor for wheeze evolving to persistent asthma. Cases who developed asthma also had an increased need of hospital time and care for wheeze during the year after inclusion.
所有学步儿童中有三分之一因急性喘息需要医疗护理，其中许多儿童在学龄期患有持续性哮喘。我们的目的是评估一组幼儿期患有急性喘息发作的儿童在7岁时哮喘的危险因素和患病率。共有113名在急性喘息发作期间纳入的儿童（病例组）和54名健康对照者从学前早期到7岁进行前瞻性随访。研究方案包括问卷调查、哮喘控制测试（ACT）、呼出一氧化氮（FeNO）检测、鼻咽病毒样本采集、血细胞计数、维生素D水平以及食物和空气传播过敏原特异性IgE的血液样本检测。7岁时哮喘的患病率在病例组中为70.8%，在对照组中为1.9%（P<0.001）。纳入时由鼻病毒（RV）感染引起的急性喘息在7岁患哮喘的病例中比未患哮喘的病例更常见（P=0.011），在对其他病毒感染进行校正后，这种关联仍然显著（比值比3.8，95%置信区间1.4 - 10.5）。与未患哮喘的病例相比，7岁患哮喘的病例在纳入后的一年内住院更频繁（P=0.024）且住院天数更多（P=0.01）。RV感染是喘息演变为持续性哮喘的主要相关因素。患哮喘的病例在纳入后的一年中对喘息的住院时间和护理需求也增加。
