P658 Association of severe viral bronchiolitis during infancy and early life with development of recurrent wheeze

Introduction Respiratory viral infections in infancy and early life, especially with allergic sensitization, are associated with higher risks of developing recurrent wheeze and asthma. Objective To analyze the association of viral bronchiolitis in infancy and early life with development of recurrent wheeze. Design and participants Retrospective study of children younger than 1 year, in our primary care setting, treated for bronchiolitis during 3 consecutive fall to winter seasons (2014–2016). Causative viruses of bronchiolitis were RSV and rhinovirus species. Development of recurrent wheeze (as defined in national asthma guidelines) by age 3 years. Results 100 infants who were treated for RSV or rhinovirus bronchiolitis. The median age was 3 months (range 1-7 months), 42 (42%) had RSV bronchiolitis, 58 (58%) had rhinovirus bronchiolitis. 42 (42%) had IgE sensitization, of which 14 (33.3%) to food, 18 (42.9%) to aeroallergens, 10 (23.8%) to food and aeroallergens combined. Overall, 39 (39%) developed recurrent wheeze by age 3 years. There was a significant interaction between viral bronchiolitis and IgE sensitization on the risk of recurrent wheeze. All children who developed recurrent wheeze also had IgE sensitization. Conclusions Infants with both bronchiolitis and IgE sensitization (to food or aeroallergens) had significantly higher risks of recurrent wheeze with subsequent development of asthma at age 3 years. It identifies infants at higher risk so we can introduce preventive measures, and enhanced follow-up.