Recurrent wheezing 36 months after bronchiolitis is associated with rhinovirus infections and blood eosinophilia

Midulla, Fabio; Nicolai, Ambra; Ferrara, Marianna; Gentile, Federico; Pierangeli, Alessandra; Bonci, Enea; Scagnolari, Carolina; Moretti, Corrado; Antonelli, Guido; Papoff, Paola

AIM: Links between respiratory syncytial virus bronchiolitis and asthma are well known, but few studies have dealt with wheezing following bronchiolitis induced by other viruses. We assessed the risk factors for recurrent wheezing in infants hospitalised for acute viral bronchiolitis. METHODS: We followed 313 infants for three years after they were hospitalised for bronchiolitis, caused by 14 different viruses, to identify risk factors for recurrent wheezing. Parents provided feedback on wheezing episodes during telephone interviews 12 (n = 266), 24 (n = 242) and 36 (n = 230) months after hospitalisation. RESULTS: The frequency of wheezing episodes diminished during the follow‐up period: 137 children (51.7%) at 12 months, 117 (48.3%) at 24 months and 93 (40.4%) at 36 months. The risk of wheeze after three years was OR = 7.2 (95% CI 3.9–13.3) if they had episodes of wheezing during the first year after bronchiolitis, 16.8 (8.7–32.7) if they had episodes of wheezing during the second year and 55.0 (22.7–133.2) if they wheezed during both years. Blood eosinophils >400 cells/μL (OR 7.7; CI 1.4–41.8) and rhinovirus infections (3.1; 1.0–9.4) were the major risk factors for recurrent wheezing. CONCLUSION: Recurrent wheezing 36 months after infant bronchiolitis was associated with rhinoviruses and blood eosinophilia.