Background: Recurrent wheezing is associated with significant morbidity and reduced quality of life in childhood, affecting an estimated one-third of preschool-aged children. Beyond the respiratory impact, it may also interfere with emotional development and family well-being. Early recognition and understanding of risk factors are essential for improving prognosis. Given its clinical importance and potential public health impact, this study aims to evaluate the characteristics of a population of children aged 4 years or younger with recurrent wheezing and to identify associated risk factors. Method: We conducted a retrospective descriptive study of a population of children aged 4 years or younger with recurrent wheezing, evaluated in a Pediatric Respiratory and Allergic Pathology consultation over a 7-month period, in a level II hospital. Results: A total of 74 children were included. Their current age was 0-4 years (median 3.0 years) and 1-24 months (median 6.0 months) at the first wheezing episode, 64.9% were male. Approximately 31.1% required hospitalization for a wheezing episode (median age 9.5 months), and 17.4% of these had multiple admissions. Two patients required transfer to the intensive care unit. Among hospitalized patients, viral isolation was not possible in 42.4%; when positive, most exacerbations were due to Respiratory Syncytial Virus (31.0%). Exposure to secondhand tobacco smoke was reported in 40.5% of cases, 44.6% had atopic dermatitis, and 52.7% had a family history of atopy. Of the children tested for allergy (52.7%), 87.2% had negative results. Conclusion: Most children presented with early-onset symptoms (median 6 months). While the clinical course was benign in most cases, a considerable proportion required hospitalization. Genetic factors (atopic predisposition) and environmental exposures (tobacco smoke) were highly prevalent in our population. The low rate of allergic sensitization may be explained by the young age at assessment, but also highlights the importance of environmental and infectious triggers in this age group. Reducing harmful exposures and ensuring close monitoring of at-risk children are key strategies to prevent morbidity associated with recurrent wheezing.
Lemos et al. (Thu,) studied this question.