Background Supervised clustering of bronchiolitis patients, according to their clinical characteristics at hospital admission, helps predict short-term hospital outcomes and the risk of developing childhood respiratory illness. Thus, we evaluated the use of wheezing status for stratifying bronchiolitis patients. Methods A prospective cohort study was conducted involving 668 previously healthy, full-term Chilean infants ( < 2 years old) hospitalized with bronchiolitis. Patients categorized based on their wheezing status at hospital admission were monitored during hospitalization and followed for 4 years after discharge. Results Wheezing children presented a more severe illness requiring more oxygen during their hospital stay. Upon discharge, they were more likely to develop preschool wheezing at 12 months and asthma at 4 years of age. Among the non-wheezing, those with RSV had more severe disease. Risk factors exclusively associated with persistent asthma development for the wheezing were clinical bacterial coinfection, parental asthma history, and having had a severe bronchiolitis episode. Risk factors exclusive for non-wheezing were maternal smoking during pregnancy and severe retractions. Conclusion Bronchiolitis patients can be categorized based on their wheezing status at hospital admission, helping predict short-term clinical outcomes and identify infants at risk of developing severe short- and long-term respiratory illnesses. Impact <UnorderedList Mark="Bullet"> <ItemContent> Stratifying viral bronchiolitis patients using a simple bedside strategy based on their wheezing status at hospitalization can help improve individual-based clinical decisions during hospitalization and enable early identification of infants with a higher risk of developing severe respiratory illnesses and long-term associated diseases. </ItemContent> <ItemContent> Viral bronchiolitis patients can be stratified based on their hospitalized wheezing status. </ItemContent> <ItemContent> Wheezing patients exhibited similar clinical patterns during hospitalization and long-term clinical outcomes upon discharge. </ItemContent> <ItemContent> Wheezing infants were more likely to develop preschool wheezing and asthma. </ItemContent> </UnorderedList>

Wheezing on admission: a marker for bronchiolitis severity and asthma development

期刊论文
发表日期：

2025年5月3日

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Patricio Astudillo,
Maria Rodriguez-Fernandez,
José A. Castro-Rodríguez,
Marcelo López-Lastra

摘要

Background

Supervised clustering of bronchiolitis patients, according to their clinical characteristics at hospital admission, helps predict short-term hospital outcomes and the risk of developing childhood respiratory illness. Thus, we evaluated the use of wheezing status for stratifying bronchiolitis patients.

Methods

A prospective cohort study was conducted involving 668 previously healthy, full-term Chilean infants ( < 2 years old) hospitalized with bronchiolitis. Patients categorized based on their wheezing status at hospital admission were monitored during hospitalization and followed for 4 years after discharge.

Results

Wheezing children presented a more severe illness requiring more oxygen during their hospital stay. Upon discharge, they were more likely to develop preschool wheezing at 12 months and asthma at 4 years of age. Among the non-wheezing, those with RSV had more severe disease. Risk factors exclusively associated with persistent asthma development for the wheezing were clinical bacterial coinfection, parental asthma history, and having had a severe bronchiolitis episode. Risk factors exclusive for non-wheezing were maternal smoking during pregnancy and severe retractions.

Conclusion

Bronchiolitis patients can be categorized based on their wheezing status at hospital admission, helping predict short-term clinical outcomes and identify infants at risk of developing severe short- and long-term respiratory illnesses.

Impact

Stratifying viral bronchiolitis patients using a simple bedside strategy based on their wheezing status at hospitalization can help improve individual-based clinical decisions during hospitalization and enable early identification of infants with a higher risk of developing severe respiratory illnesses and long-term associated diseases.

Viral bronchiolitis patients can be stratified based on their hospitalized wheezing status.

Wheezing patients exhibited similar clinical patterns during hospitalization and long-term clinical outcomes upon discharge.

Wheezing infants were more likely to develop preschool wheezing and asthma.