Recovery from Acute Asthma Exacerbations in Children: Influence of Viruses, Eczema and Atopy

Laurel Teoh, Peter Van Asperen, Jason Acworth, Mark Hurwitz, John W. Upham, C. Wang, Ian M Mackay, Theo P Sloots, Teresa Neeman, Anne Chang

    Research output: Contribution to journalMeeting Abstract

    Abstract

    Background: Acute asthma, one of the most common causes of childhood emergencies, is associated with viral infections. Although eczema and atopy are recognized as risk factors for severe asthma, the factors associated with recovery following exacerbations are not well understood.

    Aims: In children with hospitalized and non‐hospitalized asthma exacerbations, to (a) describe the point prevalence of respiratory viruses/atypical bacteria using polymerase chain reaction (PCR) and (b) evaluate the impact of respiratory viruses/atypical bacteria, eczema and atopy on acute severity and clinical recovery.

    Methods: 244 children aged 2–16 years presenting with acute asthma to the Emergency Departments of 2 hospitals were recruited. A nasopharyngeal aspirate and allergen skin prick test were performed. Asthma quality of life questionnaires for parents (PACQLQ) and validated daily diary scores for asthma were recorded for 21 and 14 days, respectively.

    Results: PCR for viruses/atypical bacteria was positive in 81.7% of children (75.1% human rhinovirus, co‐detection in 14.2%). M. pneumoniae and C. pneumoniae were rarely detected. The presence of micro‐organisms had little impact on acute asthma or recovery outcomes. Children with eczema had significantly slower asthma recovery, i.e. higher asthma diary scores on days 7, 10 and 14 (β = 0.47, 95%CI 0.09,0.85, p = 0.015; β = 0.49, 95%CI 0.10,0.88, p = 0.015; β = 0.40, 95%CI 0.02,0.78, p = 0.041 respectively) whereas children with atopy were significantly more likely to relapse and re‐present for medical care by day 14 (OR 1.11, 95%CI 1.00,1.23, p = 0.042).

    Conclusions: Viruses are associated with asthma exacerbations but do not appear to influence asthma recovery. In contrast, eczema is associated with delayed recovery from acute asthma while atopy is associated with asthma relapse.
    Original languageEnglish
    Article numberTP 060
    Pages (from-to)75-75
    Number of pages1
    JournalRespirology
    Volume19
    Issue numberS2
    DOIs
    Publication statusPublished - 24 Mar 2014

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    Teoh, L., Van Asperen, P., Acworth, J., Hurwitz, M., Upham, J. W., Wang, C., Mackay, I. M., Sloots, T. P., Neeman, T., & Chang, A. (2014). Recovery from Acute Asthma Exacerbations in Children: Influence of Viruses, Eczema and Atopy. Respirology, 19(S2), 75-75. [TP 060]. https://doi.org/10.1111/resp.12263_4