Pediatrics Department, Severo Ochoa University Hospital. Leganés, Madrid, Spain.
Alfonso X El Sabio University. Villanueva de La Cañada, Madrid, Spain.
Sci Rep. 2022 May 9;12(1):7552. doi: 10.1038/s41598-022-11356-9.
Our main objective was to compare the lung function, the rate of allergic sensitization and the prevalence of asthma at 7-9 years in children hospitalized for bronchiolitis with viral coinfection versus single viral infection. Observational study in children with previous bronchiolitis and current age 7-9 years. Clinical data were collected. Fraction of exhaled nitric oxide (FeNO) determination, spirometry and skin prick test for common aeroallergens were performed. A total of 181 children hospitalized for bronchiolitis (40 coinfections and 141 single infections), with median age of 8.3 years (IQR:7.5-9.1) were included. Single-HRV-infections showed lower basal FEV1(%) than coinfections (p = 0.04) and lower z-score FEV than single-RSV-infections (p = 0.04) or coinfections (p = 0.02). Also, single-HRV-infections had lower post-bronchodilator FEV1(%) and z-score FEV values than coinfections (p = 0.03 and p = 0.03). Single-HRV-bronchiolitis was an independent risk factor for FEV < 80% (p = 0.007). FeNO value > 25 ppb was detected in 21(12.5%) cases, without differences between viral groups (p = 0.768). The prevalence of allergic sensitization was similar in coinfections (31.4%) versus single infections (38.7%), (p = 0.428). The highest frequency of allergic rhinitis was observed in single-HRV patients (p = 0.004). The respiratory morbidity at 7-9 years of coinfected patients was similar to the single-HRV ones. In contrast, the likelihood of current asthma was up to 5 times higher in RSV/HRV coinfections than in the single-RSV-infections ones (p = 0.012). The respiratory morbidity at 7-9 years of age after severe bronchiolitis is significantly higher in single-HRV or viral coinfection patients that in single-RSV ones. Single-HRV-bronchiolitis is independently associated with lower lung function at school-age.
我们的主要目的是比较因细支气管炎住院的儿童中，病毒合并感染与单一病毒感染在 7-9 岁时的肺功能、过敏致敏率和哮喘患病率。这是一项针对有先前细支气管炎且当前年龄为 7-9 岁儿童的观察性研究。收集临床数据。进行呼出气一氧化氮（FeNO）测定、肺量测定和常见气传过敏原的皮肤点刺试验。共纳入 181 名因细支气管炎住院的儿童（40 例合并感染和 141 例单一感染），中位年龄为 8.3 岁（IQR：7.5-9.1）。单一 HRV 感染的基础 FEV1（%）低于合并感染（p=0.04），与单一 RSV 感染（p=0.04）或合并感染（p=0.02）相比，FEV1 得分较低。此外，单一 HRV 感染的支气管扩张后 FEV1（%）和 FEV1 得分低于合并感染（p=0.03 和 p=0.03）。单一 HRV 细支气管炎是 FEV<80%的独立危险因素（p=0.007）。21 例（12.5%）检测到 FeNO 值>25 ppb，病毒组之间无差异（p=0.768）。合并感染（31.4%）与单一感染（38.7%）的过敏致敏率相似（p=0.428）。单一 HRV 患者中观察到变应性鼻炎的最高频率（p=0.004）。7-9 岁时，合并感染患儿的呼吸道发病率与单一 HRV 患儿相似。相反，RSV/HRV 合并感染的患儿比单一 RSV 感染的患儿发生当前哮喘的可能性高 5 倍（p=0.012）。严重细支气管炎后 7-9 岁时的呼吸道发病率在单一 HRV 或病毒合并感染患儿中显著高于单一 RSV 感染患儿。单一 HRV 细支气管炎与学龄期较低的肺功能独立相关。
