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Research article
Yuqing Wang
Children’s Hospital of Soochow University
Corresponding Author
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Background: Infants with bronchiolitis have an increased risk of developing recurrent wheezing and asthma. However, the risk factors for the development of recurrent wheezing after bronchiolitis remains controversial.
Objective: To investigate the incidence of post-bronchiolitis recurrent wheezing and associated risk factors.
Methods: Infants with bronchiolitis were enrolled from November 2016 through March 2017. Nasopharyngeal aspirates were obtained for detection of respiratory viruses which were analyzed by reverse transcriptase polymerase chain reaction (RT-PCR) and direct immunofluorescent assay. Serum cytokines including TSLP, IL2, IL13, TIMP-1, MMP-9, IL33, IL5, IL4, IL25, TNF- α and MIP-1α were measured by flow cytometry. Patients were followed every 3 months for a duration of 2 years by telephone or at outpatient appointments.
Results: We enrolled 89 infants, of which 81 patients were successfully followed up. In total, 22.2% of patients experienced recurrent wheezing episodes. The proportion of patients with history of eczema, systemic glucocorticoid use and patients with moderate-to-severe disease were significantly higher in the recurrent wheezing group than the non-recurrent wheezing group (83.3% vs 52.4%; 66.7% vs 36.5%; 61.1% vs 33.3%, respectively, all P<0.05); There were no significant differences between patients with and without recurrent wheezing episodes in the levels of TSLP, IL2, IL13, TIMP-1, MMP-9, IL33, IL5, IL4, IL25, TNF- α and MIP-1α (P>0.05). Logistic regression analysis showed that history of eczema was an independent risk factor for post-bronchiolitis recurrent wheezing (odds ratio [OR]=5.622; 95% confidence interval [CI], 1.3–24.9; P=0.023).
Conclusion: The incidence of recurrent wheezing among infants after contracting bronchiolitis was 22.2% during a 2-year follow-up. History of eczema was the only independent risk factor identified and no correlation was found between the specific virus and disease severity in children with post-bronchiolitis recurrent wheezing.
Keywords
bbronchiolitis, eczema, recurrent wheezing
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View the published article at BMC Infectious Diseases.
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Posted 12 Jan, 2021
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Received 21 Jan, 2021
Reviewers invited
Invitations sent on 19 Jan, 2021
Reviewer #1 agreed
On 19 Jan, 2021
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On 01 Jan, 2021
Submission checks complete
On 01 Jan, 2021
Editor invited
On 01 Jan, 2021
No comments provided
Editorial decision: Major revision
On 05 Dec, 2020
Review #1 received
Received 24 Nov, 2020
Reviewers invited
Invitations sent on 17 Nov, 2020
Reviewer #1 agreed
On 17 Nov, 2020
Editor assigned
On 27 Oct, 2020
Submission checks complete
On 26 Oct, 2020
Editor invited
On 26 Oct, 2020
No comments provided
Editorial decision: Major revision
On 02 Oct, 2020
Review #3 received
Received 01 Oct, 2020
Reviewer #3 agreed
On 24 Sep, 2020
Review #1 received
Received 05 Jun, 2020
Review #2 received
Received 02 Jun, 2020
Reviewer #2 agreed
On 23 May, 2020
Reviewers invited
Invitations sent on 13 May, 2020
Reviewer #1 agreed
On 13 May, 2020
First submitted
On 29 Apr, 2020
Editor assigned
On 29 Apr, 2020
Submission checks complete
On 28 Apr, 2020
Editor invited
On 28 Apr, 2020
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Subject Areas
Infectious Diseases
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See the published version of this preprint at BMC Infectious Diseases.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Yuqing Wang
Children’s Hospital of Soochow University
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Infectious Diseases.
Version 3
Posted 12 Jan, 2021
No community comments so far
Review #1 received
Received 21 Jan, 2021
Reviewers invited
Invitations sent on 19 Jan, 2021
Reviewer #1 agreed
On 19 Jan, 2021
Editor assigned
On 01 Jan, 2021
Submission checks complete
On 01 Jan, 2021
Editor invited
On 01 Jan, 2021
No comments provided
Editorial decision: Major revision
On 05 Dec, 2020
Review #1 received
Received 24 Nov, 2020
Reviewers invited
Invitations sent on 17 Nov, 2020
Reviewer #1 agreed
On 17 Nov, 2020
Editor assigned
On 27 Oct, 2020
Submission checks complete
On 26 Oct, 2020
Editor invited
On 26 Oct, 2020
No comments provided
Editorial decision: Major revision
On 02 Oct, 2020
Review #3 received
Received 01 Oct, 2020
Reviewer #3 agreed
On 24 Sep, 2020
Review #1 received
Received 05 Jun, 2020
Review #2 received
Received 02 Jun, 2020
Reviewer #2 agreed
On 23 May, 2020
Reviewers invited
Invitations sent on 13 May, 2020
Reviewer #1 agreed
On 13 May, 2020
First submitted
On 29 Apr, 2020
Editor assigned
On 29 Apr, 2020
Submission checks complete
On 28 Apr, 2020
Editor invited
On 28 Apr, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Infectious Diseases
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Infectious Diseases.
Background: Infants with bronchiolitis have an increased risk of developing recurrent wheezing and asthma. However, the risk factors for the development of recurrent wheezing after bronchiolitis remains controversial.
Objective: To investigate the incidence of post-bronchiolitis recurrent wheezing and associated risk factors.
Methods: Infants with bronchiolitis were enrolled from November 2016 through March 2017. Nasopharyngeal aspirates were obtained for detection of respiratory viruses which were analyzed by reverse transcriptase polymerase chain reaction (RT-PCR) and direct immunofluorescent assay. Serum cytokines including TSLP, IL2, IL13, TIMP-1, MMP-9, IL33, IL5, IL4, IL25, TNF- α and MIP-1α were measured by flow cytometry. Patients were followed every 3 months for a duration of 2 years by telephone or at outpatient appointments.
Results: We enrolled 89 infants, of which 81 patients were successfully followed up. In total, 22.2% of patients experienced recurrent wheezing episodes. The proportion of patients with history of eczema, systemic glucocorticoid use and patients with moderate-to-severe disease were significantly higher in the recurrent wheezing group than the non-recurrent wheezing group (83.3% vs 52.4%; 66.7% vs 36.5%; 61.1% vs 33.3%, respectively, all P<0.05); There were no significant differences between patients with and without recurrent wheezing episodes in the levels of TSLP, IL2, IL13, TIMP-1, MMP-9, IL33, IL5, IL4, IL25, TNF- α and MIP-1α (P>0.05). Logistic regression analysis showed that history of eczema was an independent risk factor for post-bronchiolitis recurrent wheezing (odds ratio [OR]=5.622; 95% confidence interval [CI], 1.3–24.9; P=0.023).
Conclusion: The incidence of recurrent wheezing among infants after contracting bronchiolitis was 22.2% during a 2-year follow-up. History of eczema was the only independent risk factor identified and no correlation was found between the specific virus and disease severity in children with post-bronchiolitis recurrent wheezing.
Figure 1
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