Predicting worsening asthma control following the common cold.
The asthmatic response to the common cold is highly variable, and early characteristics that predict worsening of asthma control following a cold have not been identified. In this prospective multicentric cohort study of 413 adult subjects with asthma, the mini-Asthma Control Questionnaire (mini-ACQ) was used to quantify changes in asthma control and the Wisconsin Upper Respiratory Symptom Survey-21 (WURSS-21) to measure cold severity. Univariate and multivariable models were used to examine demographic, physiological, serological and cold-related characteristics for their relationship to changes in asthma control following a cold. Clinically significant worsening of asthma control was observed following a cold (mean+/-SD increase in mini-ACQ score of 0.69+/-0.93). Univariate analysis demonstrated that season, centre location, cold duration and cold severity measurements were all associated with a change in asthma control. Multivariable analysis of the covariates available within the first 2 days of cold onset revealed that the day 2 and cumulative sum of day 1 and 2 WURSS-21 scores were significant predictors of the subsequent changes in asthma control. In asthmatic subjects, cold severity within the first 2 days can be used to predict subsequent changes in asthma control. This information may help clinicians prevent deterioration in asthma control following a cold.
Walter, MJ; Castro, M; Kunselman, SJ; Chinchilli, VM; Reno, M; Ramkumar, TP; Avila, PC; Boushey, HA; Ameredes, BT; Bleecker, ER; Calhoun, WJ; Cherniack, RM; Craig, TJ; Denlinger, LC; Israel, E; Fahy, JV; Jarjour, NN; Kraft, M; Lazarus, SC; Lemanske, RF; Martin, RJ; Peters, SP; Ramsdell, JW; Sorkness, CA; Sutherland, ER; Szefler, SJ; Wasserman, SI; Wechsler, ME; National Heart, Lung and Blood Institute's Asthma Clinical Research Network,
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