University of Oulu

Dumas, O., Erkkola, R., Bergroth, E., Hasegawa, K., Mansbach, J. M., Piedra, P. A., Jartti, T., & Camargo, C. A. (2022). Severe bronchiolitis profiles and risk of asthma development in Finnish children. Journal of Allergy and Clinical Immunology, 149(4), 1281-1285.e1.

Severe bronchiolitis profiles and risk of asthma development in Finnish children

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Author: Dumas, Orianne1; Erkkola, Riku2; Bergroth, Eija3,4;
Organizations: 1Université Paris-Saclay, UVSQ, Inserm, CESP, Equipe d'Epidémiologie Respiratoire Intégrative, 94807, Villejuif, France
2Department of Children and Adolescents, Turku University Hospital and University of Turku, Turku, Finland
3Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland
4Department of Pediatrics, Central Hospital of Central Finland, Jyväskylä, Finland
5Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Mass
6Department of Pediatrics, Boston Children’s Hospital, Harvard Medical School, Boston, Mass
7Departments of Molecular Virology and Microbiology and Pediatrics, Baylor College of Medicine, Houston, Tex
8PEDEGO Research Unit, Medical Research Center, University of Oulu, Oulu, Finland
9Department of Children and Adolescents, Oulu University Hospital, Oulu, Finland
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 0.5 MB)
Persistent link:
Language: English
Published: Elsevier, 2022
Publish Date: 2023-03-08


Background: Recent studies support the existence of several entities under the clinical diagnosis of bronchiolitis. Among infants with severe bronchiolitis, distinct profiles have been differentially associated with development of recurrent wheezing by age 3 years. However, their associations with actual asthma remain unclear.

Objectives: Our aim was to study the association between severe bronchiolitis profiles identified by using a clustering approach and childhood asthma.

Methods: Among 408 children (aged <2 years) hospitalized with bronchiolitis in Finland (in 2008‐2010), latent class analysis identified 3 bronchiolitis profiles: profile A (47%), characterized by history of wheezing and/or eczema, wheezing during acute illness, and rhinovirus infection; profile BC (38%), characterized by severe illness and respiratory syncytial virus infection; and profile D (15%), characterized by the least severely ill children, including mostly children without wheezing and with rhinovirus infection. The children were followed by questionnaire 4 years later (86% [n = 348]) and through a nationwide social insurance database 7 years later (99% [n = 403]). Current asthma at the 4- and 7-year follow-ups was defined by regular use (according to parental report and medical records) or purchase (according to the social insurance database) of asthma control medication.

Results: Compared with risk of current asthma associated with profile BC, we observed increased risk of current asthma associated with profile A both at the 4-year follow-up (age- and sex-adjusted odds ratio = 2.42 [95% CI = 1.23‐4.75]) and at the 7-year follow-up (age- and sex-adjusted odds ratio = 3.14 [95% CI = 1.33‐7.42]). No significant difference in asthma risk was observed between profile D and profile BC.

Conclusions: These longitudinal results provide further support for an association between a distinct severe bronchiolitis profile (characterized by a history of wheezing and/or eczema and rhinovirus infection) and risk of development childhood asthma.

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Series: Journal of allergy and clinical immunology
ISSN: 0091-6749
ISSN-E: 1085-8725
ISSN-L: 0091-6749
Volume: 149
Issue: 4
Pages: 1281 - 1285.e1
DOI: 10.1016/j.jaci.2021.08.035
Type of Publication: A1 Journal article – refereed
Field of Science: 3123 Gynaecology and paediatrics
3121 General medicine, internal medicine and other clinical medicine
Copyright information: © 2022. This manuscript version is made available under the CC-BY-NC-ND 4.0 license