Clinical and Laboratory Profiles of Rhinovirus-Infected Preschool Children: Identifying Risk Factors for Subsequent Asthma

Peter Kunc,1,2 Jaroslav Fabry,2 Katarina Istvankova,2 Martina Neuschlova,1 Renata Pecova1 1Department of Pathological Physiology/Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin/Martin/, Bratislava, Slovakia; 2Clinic of Pediatric Respiratory Diseases and Tuberculosis/ National Institute of Pediatric Tuberculosis and Respiratory Diseases, Dolny Smokovec/ Comenius University in Bratislava, Jessenius Faculty of Medicine in Martin/ High Tatras/, Bratislava,SlovakiaCorrespondence: Renata Pecova, Email [email protected]: Rhinovirus infection is considered a significant risk factor for the development of asthma in children. However, not all children with rhinovirus infections ultimately manifest asthma.Aim of Study: To analyze the clinical and laboratory profiles of children under five years of age with proven rhinovirus infection and identify potential common factors predisposing them to an increased risk of future asthma.Materials and Methods: A retrospective longitudinal study was conducted at the National Institute of Pediatric Tuberculosis and Respiratory Diseases in Slovakia. The study population consisted of 122 preschool children (mean age 2.5 years ± 1.84, 69% boys vs 31% girls) hospitalized with PCR-confirmed rhinovirus infection. The children were followed for a minimum of three years to monitor the potential development of bronchial asthma.Results: Fifty of 122 children (41%) developed asthma (group 1), while 72 (59%) did not (group 2). Children in group 1 had a higher prevalence of family history of atopy (p < 0.001), sensitization to allergens (especially house dust mites and grass; p = 0.0002), elevated peripheral eosinophilia (p = 0.047), and higher total IgE levels (p< 0.05) compared to group 2. The use of inhaled corticosteroids was significantly higher in group 1 (p< 0.001). No significant differences were found between the groups in terms of prematurity, pathological perinatal history, and upper respiratory tract colonization by common microbial pathogens.Conclusion: Atopy, sensitization to aeroallergens, and inhaled corticosteroid use were significant risk factors for asthma development in children with rhinovirus infections. The early identification of these risk factors may help in the timely management of these children to mitigate the potential long-term consequences of chronic airway inflammation. This personalized approach allows for more intensive medical surveillance and targeted therapeutic interventions in high-risk individuals, potentially improving the long-term outcomes.Keywords: rhinovirus, bronchial asthma, children, wheezing, atopy