Newly Identified Respiratory Viruses in Children with Asthma Exacerbation Not Requiring Admission to Hospital

There are few data describing the comprehensive identification in and influence of newly identified respiratory viruses on asthma exacerbations. Most studies focus on inpatients. In this preliminary study, the point prevalence and the associations of picornavirus species described recently and human bocavirus (HBoV) with the recovery from exacerbations in non-hospitalized asthmatic children (median age 5.1 years) were examined. Human rhinoviruses (HRVs) were present in 52.6% of specimens, HBoV-1 was in 7.7%. Viral co-detections occurred in 25.6% of children and were associated (P = 0.04) with lower asthma quality of life scores upon presentation than were single viral detections. The undifferentiated presence or absence of virus did not influence the severity of asthma or recovery however when virus species were examined individually, specific clinical associations emerged. HRV species C (HRV-Cs) were the viruses most frequently detected as single virus detections. Among 41 genotyped HRVs, more HRV-Cs (n = 23) were identified than HRV-As (n = 16) however HRV-A detection was associated (P = 0.01) with worse asthma symptoms and cough for longer than was HRV-C detection. Larger, PCR-based studies are required to elucidate further the true impact of HRV species in childhood asthma exacerbations of both hospitalized and non-hospitalized cohorts.