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. 2020 Oct-Dec;13(4):600-611.
doi: 10.25122/jml-2020-0143.

Significant Clinical Associations Between Exposure Type Factors and Recurrent Wheezing and Asthma in Children

Raluca Daniela Bogdan  1 , Lidia Rusu  2 , Adrian Ioan Toma  3   4 , Leonard Nastase  5   6
Affiliations

Significant Clinical Associations Between Exposure Type Factors and Recurrent Wheezing and Asthma in Children

Raluca Daniela Bogdan et al. J Med Life. 2020 Oct-Dec.

Abstract

The study aimed to identify certain factors related to family history, pathological conditions, or exposure-type that are significantly correlated with recurrent wheezing and/or asthma in children. One hundred nine children with recurrent wheezing and 44 children with asthma were studied in order to identify the degree of correlation of these conditions with familial history of asthma or atopy, child's age group, gender, premature birth, perinatal asphyxia, neonatal infection, and antibiotic treatment during the neonatal period, history of atopy and obesity and histamine intolerance, nasopharyngeal bacterial colonization, pneumonia with bronchospasm. The clinical picture of these two diseases was also compared regarding the severity of exacerbations and their response to controller therapy. The medium age of children diagnosed with recurrent wheezing was significantly lower than those diagnosed with asthma (5.64 vs. 9.01 years; p<0.001). Inside the recurrent wheezing group, age distribution differed significantly from the asthma group (p-value <0.001). Atopy was the only pathological condition significantly associated with asthma (56.0%) when compared with the recurrent wheezing group (30.2%) with a relative risk value of 1.34 (p<0.004). For patients colonized with Staphylococcus aureus, the medium number of wheezing exacerbations was significantly higher (p<0.049). Approximately 91% of patients in the recurrent wheezing group and 71% from the asthma group responded to appropriate controller treatment. Our study showed a significant association between asthma and atopy, justifying the need to monitor asthma risk in a child with wheezing and atopy. Nasal carriage of Staphylococcus aureus proved to be significantly associated with the recurrence of wheezing in children.

Keywords: Recurrent wheezing; asthma; atopy; nasopharyngeal colonisation.

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Figures

Figure 1:
Figure 1:
Age distribution histogram for recurrent wheezing.
Figure 2:
Figure 2:
Age distribution histogram for asthma.
Figure 3:
Figure 3:
Comparison of mean age between the study groups.
Figure 4:
Figure 4:
Age distribution in the studied groups.
Figure 5:
Figure 5:
Distribution of study participants according to gender.
Figure 6:
Figure 6:
Atopy frequency among the two study groups.
Figure 7:
Figure 7:
Comparative analysis of associated conditions in both study groups.
Figure 8:
Figure 8:
Case distribution based on the occurrence of premature birth in both study groups.
Figure 9:
Figure 9:
Case distribution based on the occurrence of perinatal hypoxic injury in both study groups.
Figure 10:
Figure 10:
Case distribution based on the occurrence of infections in the neonatal period between the study groups.
Figure 11:
Figure 11:
Comparative analysis of nasopharyngeal colonization in both study groups (RW – recurrent wheezing; A – asthma).
Figure 12:
Figure 12:
Medium age for nasopharyngeal colonization in both groups.
Figure 13:
Figure 13:
Medium number of wheezing exacerbations for different nasopharyngeal bacterial colonisations.
Figure 14:
Figure 14:
Medium number of exacerbations in both study groups.
Figure 15:
Figure 15:
Case distribution based on bacterial pneumonia with bronchospasm history in the recurrent wheezing vs. asthma group.
Figure 16:
Figure 16:
Case distribution for severe exacerbations requiring hospitalization in the two study groups.
Figure 17:
Figure 17:
Case distribution based on the clinical response to controller treatment: comparative analysis in both study groups.
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