The relationship of rhinovirus-associated asthma hospitalizations with inhaled corticosteroids and smoking

J Infect Dis. 2006 Jun 1;193(11):1536-43. doi: 10.1086/503809. Epub 2006 Apr 27.


Background: Although rhinovirus (RV) respiratory infections trigger asthma exacerbations, the etiologic association between this virus and severe exacerbations, as well as the clinical characteristics of adults at risk for RV-associated asthma that necessitates hospitalization, have not been established.

Methods: During 1999-2003, we conducted a cohort study of 101 adults prospectively enrolled at hospital admission for an asthma exacerbation. Patient characteristics and frequencies of RV in nasal specimens were analyzed, by reverse-transcription polymerase chain reaction (RT-PCR), at asthma-related hospital admission and at a 3-month convalescent follow-up visit.

Results: RV was detected by RT-PCR in 21% of hospitalized patients over a 4-year period and in 1.3% of patients who returned for a 3-month follow-up visit. RV detection was strongly associated with hospitalization for asthma (adjusted odds ratio [OR], 15.1 [95% confidence interval {CI}, 1.88-121.4]). After adjustment for baseline asthma severity, RV-positive patients were more likely than RV-negative patients to be current smokers and nonusers of inhaled corticosteroids (ICSs) (adjusted OR, 11.18 [95% CI, 2.37-52.81]; P=.002).

Conclusions: RV respiratory infection is an etiologic agent in severe asthma exacerbations necessitating hospitalization in adults. Compared with hospitalized patients with asthma who were RV negative, RV-positive patients were significantly more likely to be smokers and nonusers of ICSs.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage
  • Adrenal Cortex Hormones / therapeutic use*
  • Adult
  • Asthma / epidemiology
  • Asthma / physiopathology
  • Asthma / virology*
  • Bodily Secretions / virology
  • Female
  • Follow-Up Studies
  • Hospitalization*
  • Humans
  • Immunoglobulin E / blood
  • Male
  • Middle Aged
  • Picornaviridae Infections / complications*
  • Picornaviridae Infections / epidemiology
  • Picornaviridae Infections / physiopathology
  • Picornaviridae Infections / virology
  • Prospective Studies
  • RNA, Viral / analysis
  • Reverse Transcriptase Polymerase Chain Reaction
  • Rhinovirus / isolation & purification*
  • Risk Factors
  • Seasons
  • Severity of Illness Index
  • Smoking*


  • Adrenal Cortex Hormones
  • RNA, Viral
  • Immunoglobulin E