ArticleAnnals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology2022
Viral infection and allergy status impact severity of asthma symptoms in children with asthma exacerbations.
Article in Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.
- Prevalence of respiratory viruses in stable and acute asthma: a systematic review and meta-analysis.European respiratory review : an official journal of the European Respiratory Society · 2026Pooled it
- Effects of metabolic syndrome on pulmonary infection in pediatric bronchial asthma: a narrative review.Frontiers in pediatrics · 2026Review
- Potential Determinants of Progression from Cough-Variant Asthma to Classic Asthma in Children: Evidence, Mechanisms, and Clinical Research Gaps.Journal of asthma and allergy · 2026Review
- Beyond respiratory syncytial virus and rhinovirus: The other viral respiratory bandits.Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology · 2025Review
- Prevalence and Comorbidities of Atopic Dermatitis in Korean Children and Adolescents From 1995 to 2022: A Population-Based Study.Allergy, asthma & immunology research · 2025Article
- Recurrent Infections in Allergic Pediatric Patients: An Immune System Problem? A Narrative Review.Children (Basel, Switzerland) · 2025Review
- From lockdown to recovery: changing patterns of viral infection severity in a pediatric cohort with asthma.Frontiers in allergy · 2025Article
- Effects of nonpharmaceutical interventions during COVID-19 pandemic on pediatric asthma exacerbations and viral infections.The journal of allergy and clinical immunology. Global · 2024Article
- Childhood respiratory viral infections and the microbiome.The Journal of allergy and clinical immunology · 2023Review
- Advances in the Relationship between Respiratory Viruses and Asthma.Journal of clinical medicine · 2023Review
- Article
Corrections and comments
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Authors and funding
15 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundAlthough viral infection is known to be associated with asthma exacerbations, prior research has not identified reliable predictors of acute symptom severity in virus-related asthma exacerbations (VRAEs).
objectiveTo determine the effect of asthma control and viral infection on the severity of current illness and evaluate biomarkers related to acute symptoms during asthma exacerbations.
methodsWe prospectively enrolled 120 children with physician-diagnosed asthma and current wheezing who presented to Arkansas Children's Hospital emergency department. The asthma control test (ACT) stratified controlled (ACT > 19) and uncontrolled (ACT ≤ 19) asthma, whereas pediatric respiratory symptom scores evaluated symptoms. Nasopharyngeal swabs were obtained for viral analysis, and inflammatory mediators were evaluated by nasal filter paper and Luminex assays.
resultsThere were 33 children with controlled asthma and 87 children with uncontrolled asthma. In those with uncontrolled asthma, 77% were infected with viruses during VRAE compared with 58% of those with controlled asthma. Uncontrolled subjects with VRAE had more acute symptoms compared with the controlled subjects with VRAE or uncontrolled subjects without a virus. The uncontrolled subjects with VRAE and allergy had the highest acute symptom scores (3.363 point pediatric respiratory symptom; P = .04). Children with asthma with higher symptom scores had more periostin (P = .02).
conclusionDetection of respiratory viruses is frequent in those with uncontrolled asthma. Uncontrolled subjects with viruses have more acute symptoms during exacerbations, especially in those with allergy. Periostin was highest in subjects with the most acute symptoms, regardless of control status. Taken together, these data imply synergy between viral infection and allergy in subjects with uncontrolled asthma when considering acute asthma symptoms and nasal inflammation during an exacerbation of asthma.
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