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Published online before print September 3, 2008
Eur Respir J 2008, doi:10.1183/09031936.00026808
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ORIGINAL ARTICLE

Predicting worsening asthma control following the common cold

M.J. Walter 1*, M. Castro 1, S.J. Kunselman 2, V.M. Chinchilli 2, M. Reno 1, T.P. Ramkumar 1, P.C. Avila 3, H.A. Boushey 4, B.T. Ameredes 5, E.R. Bleecker 6, W.J. Calhoun 5, R.M. Cherniack 7, T.J. Craig 2, L.C. Denlinger 8, E. Israel 9, J.V. Fahy 4, N.N. Jarjour 8, M. Kraft 10, S.C. Lazarus 4, R.F. Lemanske Jr8, R.J. Martin 7, S.P. Peters 6, J.W. Ramsdell 11, C.A. Sorkness 8, E.R. Sutherland 7, S.J. Szefler 7, S.I. Wasserman 11, M.E. Wechsler 9, for the National Heart, Lung, and Blood Institute's Asthma Clinical Research Network

1 Washington University School of Medicine, Saint Louis, MO
2 Pennsylvania State University College of Medicine, Hershey, PA
3 Northwestern University Feinberg School of Medicine, Chicago, IL
4 University of California at San Francisco, San Francisco, CA
5 University of Texas Medical Branch at Galveston, Galveston, TX
6 Wake Forest University School of Medicine, Winston-Salem, NC
7 National Jewish Medical and Research Center, Denver, CO
8 University of Wisconsin School of Medicine, Madison, WI
9 Brigham and Women's Hospital and Harvard Medical School, Boston, MA
10 Duke University School of Medicine, Durham NC
11 University of California at San Diego, San Diego, CA

* To whom correspondence should be addressed. E-mail: mwalter{at}im.wustl.edu.


  Abstract

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 multi-center cohort study of 413 adult subjects with asthma, we used the mini-Asthma Control Questionnaire (mini-ACQ) to quantify changes in asthma control and the Wisconsin Upper Respiratory Symptom Survey-21 (WURSS-21) to measure cold severity. Univariate and multivariable models examined demographic, physiologic, serologic, and cold-related characteristics for their relationship to changes in asthma control following a cold.

We observed a clinically significant worsening of asthma control following a cold (increase in mini-ACQ of 0.69±0.93). Univariate analysis demonstrated season, center location, cold length, and cold severity measurements all associated with a change in asthma control. Multivariable analysis of the covariates available within the first 2 days of cold onset revealed the day 2 and the cumulative sum of the day 1 and 2 WURSS-21 scores were significant predictors for the subsequent changes in asthma control.

In asthmatic subjects the cold severity measured 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.

Keywords:  Asthma, asthma control, common cold




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