Bronchiolitis needs a revisit: Distinguishing between virus entities and their treatments

Jartti, Tuomas; Smits, Hermelijn H.; Bønnelykke, Klaus; Bircan, Ozlem; Elenius, Varpu; Konradsen, Jon R.; Maggina, Paraskevi; Makrinioti, Heidi; Stokholm, Jakob; Hedlin, Gunilla; Papadopoulos, Nikolaos; Ruszczynski, Marek; Ryczaj, Klaudia; Schaub, Bianca; Schwarze, Jürgen; Skevaki, Chrysanthi; Stenberg-Hammar, Katarina; Feleszko, Wojciech

Apart from using merely clinical severity scores, attempts have been made in order to cluster acute bronchiolitis by phenotype. In 2016, four such phenotypes were introduced in two large multicenter studies: Profile A was characterized by RV etiology, history of wheezing, wheezing at presentation, eczema, and older age of the patient; profile B by RSV etiology, wheezing at presentation, but no history of wheezing or eczema; profile C was the most severely ill group, with a longer hospital stay and high probability of RSV infections and intensive care unit treatments; and profile D had the least severe illness, including non-wheezing children with a shorter length of hospitalization. 18 The heterogeneity apparent in the clinical profiles of the patients highlights the need for a more personalized approach in the diagnostics and management of this condition.