Background: Acute Bronchiolitis is a major cause of morbidity and mortality in infancy and early childhood worldwide. Respiratory Syncytial Virus (RSV) is the leading pathogen causing acute bronchiolitis with significant global disease burden. Acute bronchiolitis due to RSV is known to be associated with recurrent wheezing and asthma during early childhood
Objective: To assess asthma-related morbidity (asthma medications usage and increased health care utilization) in infants who experienced RSV bronchiolitis in the first year of life, during a 10-year follow-up.
Methods: A retrospective study conducted in Soroka University Medical Center during the years 2000 to 2010. We included infants that were discharged from the pediatric wards with a diagnosis of RSV bronchiolitis (positive nasal wash on ELISA). The control group included infants randomly selected from the computerized data-base of "Clalit Health Services", that had no previous admissions, matched for age, gender and primary care physician. The primary outcome was defined as the use of asthma medications (relievers, controllers and systemic corticosteroids) per year, up to 10 years of age. Furthermore, ER visits, hospitalization and total health care cost per year, were recorded during follow-up.
Results: 448 subjects were included: 231 in the RSV group and 217 in the control group. The post-RSV group consumed significantly more asthma medications per year, until the 10th year of life .
During a 10-year follow-up, there were significantly more hospitalizations in the post-RSV group (75.5% vs. 25.5%, P<0.001), due to asthma (12.6 % vs. 1.4% p<0.001), and pneumonia (31.2% vs. 4.6% p<0.001) in comparison to the control group. The estimated cost of treatment in the post-RSV group was significantly higher each year, until the 7th year follow-up. Multivariate analysis showed an odds ratio of 3 - 4.8 of consuming asthma medications among post-RSV group up to 8 years of age, adjusted to gender and gestational age (p<0.05).
Conclusion: Infants with RSV bronchiolitis have increased health care utilization (asthma medications use and respiratory-related hospitalizations) in a 10-year follow-up, when compared to a control group.
