Effect of Human Rhinovirus Species on Pediatric Asthma Exacerbation Severity

Boys 5 years of age or younger diagnosed with human rhinovirus C (HRV-C) on admission to the hospital may have a higher risk for moderate to severe asthma exacerbations, according to a study published in the Journal of Asthma.

Researchers retrospectively identified 113 children with a primary diagnosis of asthma who tested positive for HRV-C on admission to a large tertiary hospital in Melbourne, Australia. The primary objective of the study was to assess the effect of HRV-C on the severity of acute asthma exacerbations in children and adolescents diagnosed with asthma.

The researchers found that HRV species alone was not associated with moderate to severe vs mild asthma exacerbations. However, boys with HRV-C infections were found to be more likely to have a moderate to severe asthma exacerbation (odds ratio [OR]: 3.7; 95% CI, 1.2-13.4) compared with girls with HRV-C (P =.04). In addition, boys 3 and 5 years of age (OR: 9.1; 95% CI, 1.8-47.1 and OR: 3.3; 95% CI, 0.9-11.8) had higher odds compared with boys 7 years old (OR: 1.2; 95% CI, 0.2-6.6). Interestingly children diagnosed with an HRV infection but sensitized to pollen during pollen season were less likely to have a moderate to severe asthma exacerbation.

Investigators concluded that boys younger than 5 years of age diagnosed with acute asthma are at an increased risk for a moderate to severe asthma exacerbation related to HRV infection, and that sensitization to pollen during pollen season in patients with sensitivity to pollen decreases the severity of an asthma exacerbation.

Based on these findings, clinicians are encouraged to investigate pollen desensitization in patients with asthma and a known pollen sensitivity. 

Reference 

Lambert KA, Prendergast LA, Dharmage SC, et al. The role of human rhinovirus (HRV) species on asthma exacerbation severity in children and adolescents [published online October 11, 2017] J Asthma. doi:10.1080/02770903.2017.1362425