Among infants with severe bronchiolitis, those with rhinovirus (RV) at hospitalization followed by a new RV infection had the highest risk of recurrent wheezing, according to the results of a large, prospective, multicenter study published in The Journal of Infectious Diseases.

Researchers tested nasopharyngeal aspirates upon hospitalization and parents collected nasal swabs approximately 3 weeks later for respiratory viruses among 673 infants. They found that respiratory syncytial virus (RSV) delayed clearance (DC) and RV DC were not associated with recurrent wheezing, and RSV sequential infection (SI) with a different virus was rare.

The 128 infants with RV SI (19%) had nonsignificantly higher risk of recurrent wheezing (hazard ratio, 1.31; 95% CI, 0.95-1.80; P =.10) compared with infants without RV SI. In addition, the results remained the same after adjustment for preterm birth. Among infants with RV at hospitalization, those with RV SI had a higher risk of recurrent wheezing compared with children without RV SI (hazard ratio, 2.49; 95% CI, 1.22-5.06; P =.01).

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“Although the SI findings require replication, these results support further investigation examining potential differences in underlying genetics and host immune responses in infants who may be more susceptible to repeated RV infections and thus, recurrent wheezing and later, asthma exacerbations,” the researchers wrote.

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.


Mansbach, JM, Geller RJ, Hasegawa K, et al. Detection of respiratory syncytial virus or rhinovirus weeks after hospitalization for bronchiolitis and the risk of recurrent wheezing [published online June 20, 2020]. J Infect Dis. doi: 10.1093/infdis/jiaa348 

This article originally appeared on Pulmonology Advisor