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Viral and Non-viral Episodes of Wheezing in Early Life and the Development of Asthma and Respiratory Phenotypes Among Urban Children
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  • Tara N. Havens,
  • Petra LeBeau,
  • Agustin Calatroni,
  • James Gern,
  • George T. O’Connor,
  • Robert Wood,
  • Carin Lamm,
  • Rebecca Z. Krouse,
  • Cindy Visness,
  • Peter Gergen,
  • Daniel Jackson,
  • Leonard Bacharier
Tara N. Havens
University of Michigan Department of Pediatrics

Corresponding Author:thavens@med.umich.edu

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Petra LeBeau
Rho Inc
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Agustin Calatroni
Rho Inc
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James Gern
University of Wisconsin-Madison School of Medicine and Public Health
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George T. O’Connor
Boston University Department of Pediatrics
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Robert Wood
Johns Hopkins Medicine
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Carin Lamm
Columbia University Department of Pediatrics
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Rebecca Z. Krouse
Rho Inc
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Cindy Visness
Rho Inc
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Peter Gergen
National Institute of Allergy and Infectious Diseases
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Daniel Jackson
University of Wisconsin-Madison School of Medicine and Public Health
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Leonard Bacharier
Vanderbilt Department of Pediatrics
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Abstract

Background: Viral wheeze is an important risk factor for asthma, which comprises several respiratory phenotypes. We sought to understand if the etiology of early life wheezing illnesses relates to childhood respiratory and asthma phenotypes. Methods: Data were collected prospectively on 429 children in the Urban Environment and Childhood Asthma (URECA) birth cohort study through age 10 years. We identified wheezing illnesses and the corresponding viral etiology (PCR testing of nasal mucus) during the first three years of life. Six phenotypes of respiratory health were identified at 10 years of age based on trajectories of wheezing, allergic sensitization, and lung function. We compared etiology of early wheezing illnesses on these respiratory phenotypes and the development of asthma. Results: In the first three years of life, at least one virus was detected in 324 (67%) of the 483 wheezing episodes documented in the study cohort. Using hierarchical partitioning we found that non-viral wheezing episodes accounted for the greatest variance on asthma diagnosed at both 7 and 10 years of age (8.0% and 5.8% respectively). Rhinovirus wheezing illnesses explained the most variance on respiratory phenotype outcome followed by non-viral wheezing episodes (4.9% and 3.9% respectively) at 10 years of age. Conclusion and Relevance: Within this high-risk urban-residing cohort early life, non-viral wheezing episodes were frequently identified and associated with asthma development. Though rhinovirus wheezing illnesses had the greatest association with phenotype outcome, the specific etiology of wheezing episode in early life provided limited information about subsequent wheezing phenotypes.
07 Feb 2024Submitted to Pediatric Allergy and Immunology
08 Feb 2024Submission Checks Completed
08 Feb 2024Assigned to Editor
08 Feb 2024Review(s) Completed, Editorial Evaluation Pending
07 Mar 2024Editorial Decision: Revise Major
13 Jun 2024Assigned to Editor
13 Jun 2024Submission Checks Completed
13 Jun 2024Review(s) Completed, Editorial Evaluation Pending
13 Jun 2024Reviewer(s) Assigned
03 Jul 2024Editorial Decision: Accept