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Distinction between rhinovirus‐induced acute asthma and asthma‐augmented influenza infection

机译：鼻病毒诱导的急性哮喘和哮喘增强流感感染的区别

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Summary Background Rhinovirus ( RV ) is an established trigger of asthma attacks, whereas such a link is less consistent for influenza virus ( IFV ). Objective In the context of precision medicine, we hypothesized that IFV infection may cause a condition essentially different from RV , and we investigated this by evaluating clinical characteristics of RV / IFV ‐positive and ‐negative children with respiratory symptoms and/or fever. Methods One thousand two hundred and seven children, 6 months to 13 years old, hospitalized for flu‐like illness were recruited in this cross‐sectional study. Collected information included demographics, medical history, symptoms/physical findings/diagnosis at presentation and treatment. Nasal secretions were PCR ‐tested for IFV / RV . Associations were evaluated with adjusted logistic regression models. Results Rhinovirus positivity was associated with an asthma‐like presentation, including increased wheeze/effort of breathing/diagnosis of acute asthma, and decreased fever/vomiting. Conversely, IFV + children presented with less wheeze/effort of breathing/diagnosis of acute asthma, while they were more frequently febrile. In those with previous asthma history, both viruses induced wheeze; however, IFV was uniquely associated with a more generalised and severe presentation including fever, rales, intercostal muscle retractions and lymphadenopathy. These symptoms were not seen in RV + asthmatics, who had fewer systemic signs and more cough. Conclusions and Clinical relevance In children with respiratory symptoms and/or fever, RV but not IFV is associated with wheeze and an asthma‐like presentation. In those with an asthma history, IFV causes more generalised and severe disease that may be better described as “asthma‐augmented influenza” rather than an “asthma attack.” Differences in the acute conditions caused by these viruses should be considered in the design of epidemiological studies.
机译：发明内容背景rhinovirus（RV）是哮喘攻击的建立触发器，而这种联系则对流感病毒（IFV）不一致。目的在精密药物的背景下，我们假设IFV感染可能导致与RV基本上不同的病症，我们通过评估RV / IFV - 阳性和阴性儿童的临床特征来调查呼吸系统症状和/或发烧的临床特征。方法在这个横断面研究中招募了一千二百七十七名儿童，6个月至13岁，为流感疾病住院治疗。收集的信息包括人口统计学，病史，症状/物理发现/诊断和治疗。鼻中分泌物是IFV / RV的pCR。通过调整后的逻辑回归模型评估关联。结果鼻病毒阳性与哮喘的呈现有关，包括增加喘息/呼吸/诊断急性哮喘的血液，并降低发热/呕吐。相反，IFV +儿童呼吸呼吸/诊断急性哮喘的呼吸/诊断，而它们更频繁地发热。在以前的哮喘史上，这两种病毒都会引起喘息;然而，IFV与更广泛和严重的介绍的IFV唯一相关，包括发烧，戒律，肋骨腹泻和淋巴结病。在RV +哮喘学中没有看到这些症状，他们的系统性迹象较少，更咳嗽。结论和呼吸症状和/或发烧儿童的临床关键，RV但不是IFV与喘息和哮喘的介绍相关。在具有哮喘历史的人中，IFV导致更广泛和严重的疾病，可能更好地描述为“哮喘增强流感”而不是“哮喘攻击”。在流行病学研究的设计中应考虑由这些病毒引起的急性条件的差异。

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