A study of etiology and asthma risks in infants and toddlers hospitalized for recurrent or persistent wheezing

ObjectiveTo study the etiology of recurrent and persistent wheezing in infants and toddlers, and identify the risk factors for infantile asthma.MethodsWe retrospectively analyzed the data of 612 children (aged 0–36 months) hospitalized for recurrent or persistent wheezing between 2019.09.01 and 2022...

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Main Authors: Qiuwei Yi, Shanshan Liu, Jingjing Qiao, Yulan Chen, Lu Huang, Yuejie Zheng, Yanmin Bao, Kunling Shen
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-03-01
Series:Frontiers in Pediatrics
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Online Access:https://www.frontiersin.org/articles/10.3389/fped.2025.1521346/full
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author Qiuwei Yi
Shanshan Liu
Jingjing Qiao
Yulan Chen
Lu Huang
Yuejie Zheng
Yanmin Bao
Kunling Shen
author_facet Qiuwei Yi
Shanshan Liu
Jingjing Qiao
Yulan Chen
Lu Huang
Yuejie Zheng
Yanmin Bao
Kunling Shen
author_sort Qiuwei Yi
collection DOAJ
description ObjectiveTo study the etiology of recurrent and persistent wheezing in infants and toddlers, and identify the risk factors for infantile asthma.MethodsWe retrospectively analyzed the data of 612 children (aged 0–36 months) hospitalized for recurrent or persistent wheezing between 2019.09.01 and 2022.08.31. We comparatively analyzed their clinical, laboratory, imaging, and lung-examination data between different groups. Multivariate logistic regression analysis was used to identify risk factors for asthma.ResultsThe etiologies of recurrent and persistent wheezing significantly differed (P < 0.05). The top 3 causes of recurrent wheezing were viral infections (48.4%), infantile asthma (28.0%), and protracted bacterial bronchitis (PBB; 9.5%), whereas the top 3 causes of persistent wheezing were PBB (67.5%), tracheomalacia (22.2%), and infantile asthma (15.9%). The distribution of etiologies varied by age. Bronchoscopy was performed for 181 children, and mainly showed purulent changes (34.3%), tracheomalacia (27.1%), and positive pathogenic bronchoalveolar lavage fluid (25.4%). Older age, admission to the intensive care unit (ICU), positive modified Asthma Prediction Index (mAPI), and food allergy were risk factors for asthma. The odds ratio of mAPI was 4.066. The area under the receiver operating characteristic curve of the risk factors for predicting asthma was 0.8016.ConclusionWheezing phenotype and age may partly guide the etiological diagnosis of recurrent/persistent wheezing in infants and young children. Bronchoscopy is important for the diagnosis of refractory recurrent/persistent wheezing, while mAPI aids in the diagnosis of asthma. When infants and children with recurrent or persistent wheezing have the characteristics of older age, ICU admission, positive mAPI, and food allergy, the possibility of asthma may be considered.
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spelling doaj-art-3cae84d9c4e04711aee171f167493b292025-08-20T02:10:50ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-03-011310.3389/fped.2025.15213461521346A study of etiology and asthma risks in infants and toddlers hospitalized for recurrent or persistent wheezingQiuwei Yi0Shanshan Liu1Jingjing Qiao2Yulan Chen3Lu Huang4Yuejie Zheng5Yanmin Bao6Kunling Shen7Respiratory Department, Beijing Children Hospital, Capital Medical University, China National Clinical Research Center of Respiratory Diseases, National Center for Children Health, Beijing, ChinaRespiratory Department, Shenzhen Children’s Hospital, Shenzhen, ChinaRespiratory Department, Shenzhen Children’s Hospital, Shenzhen, ChinaClinical Research Laboratory, Shenzhen Children’s Hospital, Shenzhen, ChinaRespiratory Department, Shenzhen Children’s Hospital, Shenzhen, ChinaRespiratory Department, Shenzhen Children’s Hospital, Shenzhen, ChinaRespiratory Department, Shenzhen Children’s Hospital, Shenzhen, ChinaRespiratory Department, Beijing Children Hospital, Capital Medical University, China National Clinical Research Center of Respiratory Diseases, National Center for Children Health, Beijing, ChinaObjectiveTo study the etiology of recurrent and persistent wheezing in infants and toddlers, and identify the risk factors for infantile asthma.MethodsWe retrospectively analyzed the data of 612 children (aged 0–36 months) hospitalized for recurrent or persistent wheezing between 2019.09.01 and 2022.08.31. We comparatively analyzed their clinical, laboratory, imaging, and lung-examination data between different groups. Multivariate logistic regression analysis was used to identify risk factors for asthma.ResultsThe etiologies of recurrent and persistent wheezing significantly differed (P < 0.05). The top 3 causes of recurrent wheezing were viral infections (48.4%), infantile asthma (28.0%), and protracted bacterial bronchitis (PBB; 9.5%), whereas the top 3 causes of persistent wheezing were PBB (67.5%), tracheomalacia (22.2%), and infantile asthma (15.9%). The distribution of etiologies varied by age. Bronchoscopy was performed for 181 children, and mainly showed purulent changes (34.3%), tracheomalacia (27.1%), and positive pathogenic bronchoalveolar lavage fluid (25.4%). Older age, admission to the intensive care unit (ICU), positive modified Asthma Prediction Index (mAPI), and food allergy were risk factors for asthma. The odds ratio of mAPI was 4.066. The area under the receiver operating characteristic curve of the risk factors for predicting asthma was 0.8016.ConclusionWheezing phenotype and age may partly guide the etiological diagnosis of recurrent/persistent wheezing in infants and young children. Bronchoscopy is important for the diagnosis of refractory recurrent/persistent wheezing, while mAPI aids in the diagnosis of asthma. When infants and children with recurrent or persistent wheezing have the characteristics of older age, ICU admission, positive mAPI, and food allergy, the possibility of asthma may be considered.https://www.frontiersin.org/articles/10.3389/fped.2025.1521346/fullinfantsyoung childrenrecurrent wheezingpersistent wheezingetiologyinfantile asthma
spellingShingle Qiuwei Yi
Shanshan Liu
Jingjing Qiao
Yulan Chen
Lu Huang
Yuejie Zheng
Yanmin Bao
Kunling Shen
A study of etiology and asthma risks in infants and toddlers hospitalized for recurrent or persistent wheezing
Frontiers in Pediatrics
infants
young children
recurrent wheezing
persistent wheezing
etiology
infantile asthma
title A study of etiology and asthma risks in infants and toddlers hospitalized for recurrent or persistent wheezing
title_full A study of etiology and asthma risks in infants and toddlers hospitalized for recurrent or persistent wheezing
title_fullStr A study of etiology and asthma risks in infants and toddlers hospitalized for recurrent or persistent wheezing
title_full_unstemmed A study of etiology and asthma risks in infants and toddlers hospitalized for recurrent or persistent wheezing
title_short A study of etiology and asthma risks in infants and toddlers hospitalized for recurrent or persistent wheezing
title_sort study of etiology and asthma risks in infants and toddlers hospitalized for recurrent or persistent wheezing
topic infants
young children
recurrent wheezing
persistent wheezing
etiology
infantile asthma
url https://www.frontiersin.org/articles/10.3389/fped.2025.1521346/full
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