European Respiratory Society

Predicting worsening asthma control following the common cold

M. J. Walter, M. Castro, S. J. Kunselman, V. M. Chinchilli, M. Reno, T. P. Ramkumar, P. C. Avila, H. A. Boushey, B. T. Ameredes, E. R. Bleecker, W. J. Calhoun, R. M. Cherniack, T. J. Craig, L. C. Denlinger, E. Israel, J. V. Fahy, N. N. Jarjour, M. Kraft, S. C. Lazarus, R. F. Lemanske, R. J. Martin, S. P. Peters, J. W. Ramsdell, C. A. Sorkness, E. R. Sutherland, S. J. Szefler, S. I. Wasserman, M. E. Wechsler, the National Heart, Lung and Blood Institute’s Asthma Clinical Research Network


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.


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