Prospective cohort of 206 children with their first episode of RSV-confirmed bronchiolitis in the first year of life, 122 had spirometry performed at least twice between 5-16 years of age. Methacholine bronchoprovocation was available in 127 and 79 children at 7 and 12 years of age, respectively. Longitudinal changes in FEV , FVC, and FEV /FVC z-scores and methacholine PC were analyzed.
55% of the study cohort (N=122) were male and 55% were Caucasian. During follow-up, longitudinal changes in z-scores for pre- and post-bronchodilator FEV (P < 0.0001) FVC (P<0.0001) and FEV /FVC (P< 0.0001 for pre- and 0.007 for postbronchodilator) from age 5 to 10-16 years were observed. Declined lung function in late childhood was significantly associated with gender, physician-diagnosis of asthma, and allergic sensitization. PC geometric mean increased from 0.28 mg/ml at 7 years to 0.53 mg/ml at 12 years of age, and the frequency of abnormal bronchial hyperreactivity decreased from 96% to 78% (P =0.0003).
Following severe RSV bronchiolitis, there appear to be significant longitudinal changes in pre- and post-bronchodilator lung function during childhood. The study has several limitations including significant drop-outs and the lack of a control group and postbronchodilator measurements. Bronchial hyperreactivity is common in children following severe RSV bronchiolitis; however, it appears to decrease as they enter late childhood.
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