The relationship of rhinovirus-associated asthma hospitalizations with inhaled corticosteroids and smoking.

Venarske DL, Busse WW, Griffin MR, Gebretsadik T, Shintani AK, Minton PA, Peebles RS, Hamilton R, Weisshaar E, Vrtis R, Higgins SB, Hartert TV
J Infect Dis. 2006 193 (11): 1536-43

PMID: 16652282 · PMCID: PMC7109695 · DOI:10.1086/503809

BACKGROUND - Although rhinovirus (RV) respiratory infections trigger asthma exacerbations, the etiologic association between this virus and severe exacerbations, as well as the clinical characteristics of adults at risk for RV-associated asthma that necessitates hospitalization, have not been established.

METHODS - During 1999-2003, we conducted a cohort study of 101 adults prospectively enrolled at hospital admission for an asthma exacerbation. Patient characteristics and frequencies of RV in nasal specimens were analyzed, by reverse-transcription polymerase chain reaction (RT-PCR), at asthma-related hospital admission and at a 3-month convalescent follow-up visit.

RESULTS - RV was detected by RT-PCR in 21% of hospitalized patients over a 4-year period and in 1.3% of patients who returned for a 3-month follow-up visit. RV detection was strongly associated with hospitalization for asthma (adjusted odds ratio [OR], 15.1 [95% confidence interval {CI}, 1.88-121.4]). After adjustment for baseline asthma severity, RV-positive patients were more likely than RV-negative patients to be current smokers and nonusers of inhaled corticosteroids (ICSs) (adjusted OR, 11.18 [95% CI, 2.37-52.81]; P=.002).

CONCLUSIONS - RV respiratory infection is an etiologic agent in severe asthma exacerbations necessitating hospitalization in adults. Compared with hospitalized patients with asthma who were RV negative, RV-positive patients were significantly more likely to be smokers and nonusers of ICSs.

MeSH Terms (20)

Adrenal Cortex Hormones Adult Asthma Bodily Secretions Female Follow-Up Studies Hospitalization Humans Immunoglobulin E Male Middle Aged Picornaviridae Infections Prospective Studies Reverse Transcriptase Polymerase Chain Reaction Rhinovirus Risk Factors RNA, Viral Seasons Severity of Illness Index Smoking

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