, vol. 88, issue 7, pp. 52-56, 2013.
Viral respiratory infections are associated with nearly 80% of asthma exacerbation
episodes. These can have severe adverse outcomes in patients with established
asthma.
Aim
The aim of the study was to identify the viral causes of acute respiratory infection that
precipitate acute asthma exacerbation in Egyptian asthmatic children.
Patients and methods
The current prospective study was conducted in Cairo University Children’s Hospitals
from December 2010 to December 2011. All asthmatic children (n= 130) aged 2–12
years admitted with asthma exacerbation due to severe lower respiratory tract infection
were included. All cases were subjected to nasopharyngeal or throat swabs that were
analyzed for common respiratory viruses, including respiratory syncytial virus (RSV),
human metapneumovirus (hMPV), influenza B (Flu B), human parainfluenza virus
(hPIV), influenza A (H1N1), and adenovirus (ADV) using the real-time PCR technique.
All patients were followed up to record the outcome.
Results
PCR analysis was positive for one respiratory virus in 54 asthmatic patients (41.5%)
and was negative in 76 patients (58.5%), with a high predominance of RSV (51.9%)
and hMPV (25.9%) especially in winter and early spring months. Hypoxia was detected
in all patients with RSV infection; of these patients, 21.4% were admitted to the ICU,
14.3% required mechanical ventilation, and 14.3% died. In contrast, among those with
hMPV infection, hypoxia was detected in 71.4%; none required ICU admission or
mechanical ventilation.
Conclusion and recommendations
Viral etiology of lower respiratory tract infections constitutes an important cause of
acute asthma exacerbation in asthmatic children admitted to children’s hospitals in
Cairo, supporting the need for large-scale multicentric studies on asthmatic patients
over multiple years using a wider-panel PCR for detection of respiratory viruses.
