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Email: goto21bakerst@gmail.com; Tel.: +1-617-726-5276; Fax: +1-617-724-4050

M.N. drafted the initial manuscript, revised the initial manuscript, and approved the final manuscript as submitted. A.C. and X.L. carried out the main statistical analysis, created figures, reviewed and revised the initial manuscript, and approved the final manuscript as submitted. J.B.S., A.N.A., J.L.A., D.D., A.L.D., A.J.E., J.E.G., T.H., J.H., G.K.K.H., A.E.H., M.R.K., C.J.K., L.D.L., A.A.L., C.T.M., R.L.M., E.O., T.M.O., N.P., S.T.W., R.O.W., R.J.W., K.N.C., X.Z., Q.Z. and E.Z. obtained funding, measured the data, reviewed and revised the initial manuscript, and approved the final manuscript as submitted. C.A.C.J. and K.H. conceptualized the study, obtained funding, supervised the statistical analysis, reviewed and revised the initial manuscript, and approved the final manuscript as submitted. All authors have read and agreed to the published version of the manuscript.

We thank the ECHO study sites and research personnel for their ongoing dedication to bronchiolitis and asthma research (see Table S1). We also thank Clancy Blair, Sean Deoni, Cristiane Duarte, Assiamira Ferrara, Barry Lester, Craig Newschaffer, Irva Picciotto, Leonardo Trasande, Christine Johnson, Leonard Bacharier, and Kate Keenan for their helpful contributions.

Hasegawa has received grants for asthma-related research from Novartis and Teva. Camargo has participated in asthma-related scientific advisory boards for AstraZeneca and Sanofi. Gern received consulting fees from Meissa Vaccines Inc. and AstraZeneca. Hartert received consulting fees from Sanofi and participated in an advisory board for Pfizer. Litonjua received royalties from UpToDate. Weiss received royalties from UpToDate and is on the board of Histolix, a digital pathology company. The other authors have no conflicts of interest relevant to this article to disclose.

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Research Funding:

This work was supported by grants from the National Institutes of Health (UG3/UH3 OD023244, UG3/UH3 OD023248, UG3/UH3 OD023253, UG3/UH3 OD023268, UG/UH3 OD023271, UG3/UH3 OD023275, UG3/UH3 OD023279, UG3/UH3 OD023282, UH3/UH3 OD023286, UG3/UH3 OD023288, UG3/UH3 OD023290, UG3/UH3 OD023318, UG3/UH3 OD023337, UG3/UH3 OD023348, and UG3/UH3 OD023389). The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The funding organizations were not involved in the collection, management, or analysis of the data; the preparation or approval of the manuscript; or the decision to submit the manuscript for publication.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Biochemistry & Molecular Biology
  • Medicine, Research & Experimental
  • Pharmacology & Pharmacy
  • Research & Experimental Medicine
  • asthma
  • bronchiolitis
  • children
  • cohort
  • generalizability
  • heterogeneity
  • SYNCYTIAL VIRUS BRONCHIOLITIS
  • RSV BRONCHIOLITIS
  • UNITED-STATES
  • RISK
  • GENETICS
  • CHILDREN
  • PREVENTION
  • ALLERGIES
  • OUTCOMES
  • ECZEMA

Association of Severe Bronchiolitis during Infancy with Childhood Asthma Development: An Analysis of the ECHO Consortium

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Journal Title:

BIOMEDICINES

Volume:

Volume 11, Number 1

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Type of Work:

Article | Final Publisher PDF

Abstract:

Objective: Many studies have shown that severe (hospitalized) bronchiolitis during infancy is a risk factor for developing childhood asthma. However, the population subgroups at the highest risk remain unclear. Using large nationwide pediatric cohort data, namely the NIH Environmental influences on Child Health Outcomes (ECHO) Program, we aimed to quantify the longitudinal relationship of bronchiolitis hospitalization during infancy with asthma in a generalizable dataset and to examine potential heterogeneity in terms of major demographics and clinical factors. Methods: We analyzed data from infants (age <12 months) enrolled in one of the 53 prospective cohort studies in the ECHO Program during 2001–2021. The exposure was bronchiolitis hospitalization during infancy. The outcome was a diagnosis of asthma by a physician by age 12 years. We examined their longitudinal association and determined the potential effect modifications of major demographic factors. Results: The analytic cohort consisted of 11,762 infants, 10% of whom had bronchiolitis hospitalization. Overall, 15% subsequently developed asthma. In the Cox proportional hazards model adjusting for 10 patient-level factors, compared with the no-bronchiolitis hospitalization group, the bronchiolitis hospitalization group had a significantly higher rate of asthma (14% vs. 24%, HR = 2.77, 95%CI = 2.24–3.43, p < 0.001). There was significant heterogeneity by race and ethnicity (Pinteraction = 0.02). The magnitude of the association was greater in non-Hispanic White (HR = 3.77, 95%CI = 2.74–5.18, p < 0.001) and non-Hispanic Black (HR = 2.39, 95%CI = 1.60–3.56; p < 0.001) infants, compared with Hispanic infants (HR = 1.51, 95%CI = 0.77–2.95, p = 0.23). Conclusions: According to the nationwide cohort data, infants hospitalized with bronchiolitis are at a higher risk for asthma, with quantitative heterogeneity in different racial and ethnic groups.

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© 2022 by the authors.

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
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