Association between early respiratory viral infections and structural lung disease in infants with cystic fibrosis

doi:10.1016/j.jcf.2022.04.014

. 2022 Nov;21(6):1020-1026.

doi: 10.1016/j.jcf.2022.04.014. Epub 2022 May 4.

Association between early respiratory viral infections and structural lung disease in infants with cystic fibrosis

Affiliations

¹ Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA. Electronic address: dbsand@iu.edu.
² Department of Pediatrics, University of Nebraska Medical Center, Children's Hospital and Medical Center, Omaha, NE, USA.
³ Department of Pediatrics, UNC Children's, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.
⁴ Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, USA.
⁵ Department of Paediatrics, Erasmus MC - Sophia Children's Hospital, University Medial Center Rotterdam, Netherlands; Department of Radiology and Nuclear Medicine, Erasmus MC - Sophia Children's Hospital, University Medial Center Rotterdam, Netherlands.
⁶ The Centre for Microscopy, Characterisation and Analysis, The University of Western Australia, Nedlands, Western Australia; Children's Lung Health, Wal-yan Respiratory Research Centre, Telethon Kids Institute and School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia.
⁷ Department of Pediatrics, Washington University, St. Louis Children's Hospital, St. Louis, MO, USA.
⁸ Children's Lung Health, Wal-yan Respiratory Research Centre, Telethon Kids Institute and School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia.
⁹ Department of Pediatrics, University of Western Australia, Telethon Kids Institute, Perth, Australia.
¹⁰ Department of Respiratory and Sleep Medicine, Royal Children's Hospital, Parkville, Australia; Infection and Immunity, Murdoch Children's Research Institute, Parkville, Australia; Department of Paediatrics, University of Melbourne, Parkville, Australia.

PMID: 35523715
PMCID: PMC10564322
DOI: 10.1016/j.jcf.2022.04.014

Association between early respiratory viral infections and structural lung disease in infants with cystic fibrosis

Don B Sanders et al. J Cyst Fibros. 2022 Nov.

. 2022 Nov;21(6):1020-1026.

doi: 10.1016/j.jcf.2022.04.014. Epub 2022 May 4.

Affiliations

¹ Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA. Electronic address: dbsand@iu.edu.
² Department of Pediatrics, University of Nebraska Medical Center, Children's Hospital and Medical Center, Omaha, NE, USA.
³ Department of Pediatrics, UNC Children's, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.
⁴ Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, USA.
⁵ Department of Paediatrics, Erasmus MC - Sophia Children's Hospital, University Medial Center Rotterdam, Netherlands; Department of Radiology and Nuclear Medicine, Erasmus MC - Sophia Children's Hospital, University Medial Center Rotterdam, Netherlands.
⁶ The Centre for Microscopy, Characterisation and Analysis, The University of Western Australia, Nedlands, Western Australia; Children's Lung Health, Wal-yan Respiratory Research Centre, Telethon Kids Institute and School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia.
⁷ Department of Pediatrics, Washington University, St. Louis Children's Hospital, St. Louis, MO, USA.
⁸ Children's Lung Health, Wal-yan Respiratory Research Centre, Telethon Kids Institute and School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia.
⁹ Department of Pediatrics, University of Western Australia, Telethon Kids Institute, Perth, Australia.
¹⁰ Department of Respiratory and Sleep Medicine, Royal Children's Hospital, Parkville, Australia; Infection and Immunity, Murdoch Children's Research Institute, Parkville, Australia; Department of Paediatrics, University of Melbourne, Parkville, Australia.

PMID: 35523715
PMCID: PMC10564322
DOI: 10.1016/j.jcf.2022.04.014

Abstract

Background: Infants with cystic fibrosis (CF) develop structural lung disease early in life, and viral infections are associated with progressive lung disease. We hypothesized that the presence of respiratory viruses would be associated with structural lung disease on computed tomography (CT) of the chest in infants with CF.

Methods: Infants with CF were enrolled before 4 months of age. Multiplex PCR assays were performed on nasal swabs to detect respiratory viruses during routine visits and when symptomatic. Participants underwent CT imaging at approximately 12 months of age. Associations between Perth-Rotterdam Annotated Grid Morphometric Analysis for CF (PRAGMA-CF) CT scores and respiratory viruses and symptoms were assessed with Spearman correlation coefficients.

Results: Sixty infants were included for analysis. Human rhinovirus was the most common virus detected, on 28% of tested nasal swabs and in 85% of participants. The median (IQR) extent of lung fields that was healthy based on PRAGMA-CF was 98.7 (0.8)%. There were no associations between PRAGMA-CF and age at first virus, or detection of any virus, including rhinovirus, respiratory syncytial virus, or parainfluenza. The extent of airway wall thickening was associated with ever having wheezed (ρ = 0.31, p = 0.02) and number of encounters with cough (ρ = 0.25, p = 0.0495).

Conclusions: Infants with CF had minimal structural lung disease. We did not find an association between respiratory viruses and CT abnormalities. Wheezing and frequency of cough were associated with early structural changes.

Keywords: Chest computed tomography; Cystic fibrosis; Newborn screening; Respiratory infection; Viruses.

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Figures

**Figure 1.**
Box and whisker plot for Ever/Never virus positive and (A) % Total airways disease and (B) % Airway wall thickening.

See this image and copyright information in PMC

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References

1. Sly PD, Gangell CL, Chen L, Ware RS, Ranganathan S, Mott LS, et al. Risk factors for bronchiectasis in children with cystic fibrosis. N Engl J Med. 2013;368(21):1963–70. - PubMed
1. Hiatt PW, Grace SC, Kozinetz CA, Raboudi SH, Treece DG, Taber LH, et al. Effects of viral lower respiratory tract infection on lung function in infants with cystic fibrosis. Pediatrics. 1999;103(3):619–26. - PubMed
1. van Ewijk BE, van der Zalm MM, Wolfs TF, Fleer A, Kimpen JL, Wilbrink B, et al. Prevalence and impact of respiratory viral infections in young children with cystic fibrosis: prospective cohort study. Pediatrics. 2008;122(6):1171–6. - PubMed
1. Wat D, Gelder C, Hibbitts S, Cafferty F, Bowler I, Pierrepoint M, et al. The role of respiratory viruses in cystic fibrosis. J Cyst Fibros. 2008;7(4):320–8. - PMC - PubMed
1. Esther CR Jr., Lin FC, Kerr A, Miller MB, Gilligan PH. Respiratory viruses are associated with common respiratory pathogens in cystic fibrosis. Pediatr Pulmonol. 2014;49(9):926–31. - PubMed

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[1] Sly PD, Gangell CL, Chen L, Ware RS, Ranganathan S, Mott LS, et al. Risk factors for bronchiectasis in children with cystic fibrosis. N Engl J Med. 2013;368(21):1963–70. - PubMed

[2] Sly PD, Gangell CL, Chen L, Ware RS, Ranganathan S, Mott LS, et al. Risk factors for bronchiectasis in children with cystic fibrosis. N Engl J Med. 2013;368(21):1963–70. - PubMed

[3] Hiatt PW, Grace SC, Kozinetz CA, Raboudi SH, Treece DG, Taber LH, et al. Effects of viral lower respiratory tract infection on lung function in infants with cystic fibrosis. Pediatrics. 1999;103(3):619–26. - PubMed

[4] Hiatt PW, Grace SC, Kozinetz CA, Raboudi SH, Treece DG, Taber LH, et al. Effects of viral lower respiratory tract infection on lung function in infants with cystic fibrosis. Pediatrics. 1999;103(3):619–26. - PubMed

[5] van Ewijk BE, van der Zalm MM, Wolfs TF, Fleer A, Kimpen JL, Wilbrink B, et al. Prevalence and impact of respiratory viral infections in young children with cystic fibrosis: prospective cohort study. Pediatrics. 2008;122(6):1171–6. - PubMed

[6] van Ewijk BE, van der Zalm MM, Wolfs TF, Fleer A, Kimpen JL, Wilbrink B, et al. Prevalence and impact of respiratory viral infections in young children with cystic fibrosis: prospective cohort study. Pediatrics. 2008;122(6):1171–6. - PubMed

[7] Wat D, Gelder C, Hibbitts S, Cafferty F, Bowler I, Pierrepoint M, et al. The role of respiratory viruses in cystic fibrosis. J Cyst Fibros. 2008;7(4):320–8. - PMC - PubMed

[8] Wat D, Gelder C, Hibbitts S, Cafferty F, Bowler I, Pierrepoint M, et al. The role of respiratory viruses in cystic fibrosis. J Cyst Fibros. 2008;7(4):320–8. - PMC - PubMed

[9] Esther CR Jr., Lin FC, Kerr A, Miller MB, Gilligan PH. Respiratory viruses are associated with common respiratory pathogens in cystic fibrosis. Pediatr Pulmonol. 2014;49(9):926–31. - PubMed

[10] Esther CR Jr., Lin FC, Kerr A, Miller MB, Gilligan PH. Respiratory viruses are associated with common respiratory pathogens in cystic fibrosis. Pediatr Pulmonol. 2014;49(9):926–31. - PubMed

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Association between early respiratory viral infections and structural lung disease in infants with cystic fibrosis

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Association between early respiratory viral infections and structural lung disease in infants with cystic fibrosis

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