Investigating the effects of viral lower respiratory tract infections during the first five years of life on subsequent lung diseases

OBJECTIVE: Viral lower respiratory tract infections (LRTI) in early childhood may affect the growth and development of the lungs, Whether bronchiolitis leads to later development of asthma is debatable since many factors such as genetic discrepancies, smoke exposure, and immunological mechanisms may be responsible. In this study we aimed to investigate short term clinical prognosis of children with past viral LRTI in a single center. MATERIAL and METHODS: The data of the patients included in the study were obtained from a previous study evaluating viral respiratory etiology among children attending to emergency department between 1 March 2015 and 31 January 2016. Among 95 patients, 17 were excluded because of inadequate follow up, Group 1 (patients with virus detection) were compared to Group 2 (patients with no virus detection) for development respiratory tract disease in the subsequent years. Telephone interview with the families was organized to identify any respiratory problems after hospital discharge. Additionally, data on the hospital automation system was overviewed for further admissions and laboratory workup. Demographic features, future respiratory complaints, physical examination findings, diagnoses, test results (if any) were recorded. Informed consent was obtained by informing the parents of the patients, verbally. The frequency of developing respiratory tract disease during followup was compared between those who had viral LRTI with those who had non-viral LRTI. RESULTS: Among 78 cases 43 (55.1%) were male male. 35 (44.9%) were female. The rate of hospital readmissions (both outpatient and emergency center), presence of rhonci and prolonged expiratory phase of respiration during readmissions was significantly higher (p<0.05) in Group 1 than in Group 2. Among patients who had RSV, RV and hBoV detected at first admission, 58.3%, 46.1%, and 54.5% were diagnosed as asthma, and 83.3%, 77.9% and 81.8% were readmitted due to recurrent wheezing, respectively. Acute bronchitis rate was significantly higher (p<0.05) in patients with nasopharyngeal bacterial colonization than those with no bacterial presence. CONCLUSION: In this study, patients with prior viral LRTI were more likely to get re-hospitalized due to respiratory reasons.experience subsequent recurrent wheezing,VIII and diagnosed as asthma in the follow-up. It is suggested that future studies should focus on the mechanisms why these risks occur and how they can be prevented.