{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T07:52:07Z","timestamp":1791273127716,"version":"4.1.0"},"reference-count":40,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100023771","name":"Fabrikant Vilhelm Pedersen og Hustrus Legat","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100023771","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Allergy Immunology"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Asthma\u2010like episodes with cough, wheeze and\/or breathlessness are frequent in young children and often triggered by respiratory tract infections. We aimed to examine whether specific microbial triggers of asthma\u2010like episodes were associated with episode duration and severity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed 453 nasopharyngeal aspirates collected during acute asthma\u2010like episodes from 268 children aged 0\u20133\u2009years from the COPSAC\u20102010 cohort. Samples were tested for common pathogenic respiratory viruses by PCR and for bacteria by culture. Asthma\u2010like episodes were prospectively recorded in diaries. Associations between microbial triggers and episode duration and severity were analyzed by generalized estimating equations. Interactions between microbial triggers and selected asthma risk loci and polygenic risk scores (PRSs) were explored in relation to episode duration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Rhinovirus was associated with 27% longer episode duration compared to episodes without rhinovirus, predominantly driven by rhinovirus C (50% longer). Rhinovirus was also associated with a more than twofold increased risk of a severe asthma exacerbation (i.e., need for oral prednisolone, high\u2010dose inhaled corticosteroids, and\/or hospitalization) (OR 2.26; 95% CI 1.10\u20134.64;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.027), with rhinovirus C exhibiting an even higher risk (OR 4.38; 95% CI 1.71\u201311.25;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.002). Episodes with\n                      <jats:italic>Streptococcus pneumoniae<\/jats:italic>\n                      ,\n                      <jats:italic>Haemophilus influenzae<\/jats:italic>\n                      , and\/or\n                      <jats:italic>Moraxella catarrhalis<\/jats:italic>\n                      were associated with 61% longer duration than episodes without these bacteria, which was particularly pronounced for\n                      <jats:italic>M. catarrhalis<\/jats:italic>\n                      (47% longer). In contrast, RSV; parainfluenza and influenza viruses were associated with shorter duration. Younger age correlated with longer episode duration and risk of a severe asthma exacerbation. Exploratory analyses suggested pathogen\u2010specific interactions with selected asthma risk loci and asthma exacerbartion PRS in relation to episode duration.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Specific microbial triggers and younger age were associated with the duration and severity of asthma\u2010like episodes in young children. These findings may improve prognostic assessment and support more individualized management.<\/jats:p>\n                    <jats:p>\n                      <jats:boxed-text content-type=\"graphic\" position=\"anchor\">\n                        <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/pai70499-gra-0001-m.png\">\n                          <jats:alt-text>image<\/jats:alt-text>\n                        <\/jats:graphic>\n                      <\/jats:boxed-text>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pai.70499","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T07:11:23Z","timestamp":1791270683000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Duration and severity of asthma\u2010like episodes in young children vary by viral and bacterial triggers"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8089-861X","authenticated-orcid":false,"given":"Julie Nyholm","family":"Kyvsgaard","sequence":"first","affiliation":[{"name":"COPSAC, Copenhagen Prospective Studies on Asthma in Childhood Copenhagen University Hospital, Herlev\u2010Gentofte  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0200-0461","authenticated-orcid":false,"given":"Jonathan","family":"Thorsen","sequence":"additional","affiliation":[{"name":"COPSAC, Copenhagen Prospective Studies on Asthma in Childhood Copenhagen University Hospital, Herlev\u2010Gentofte  Copenhagen Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3375-6555","authenticated-orcid":false,"given":"Signe Kjeldgaard","family":"Jensen","sequence":"additional","affiliation":[{"name":"COPSAC, Copenhagen Prospective Studies on Asthma in Childhood Copenhagen University Hospital, Herlev\u2010Gentofte  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6049-1683","authenticated-orcid":false,"given":"Tamo","family":"Sultan","sequence":"additional","affiliation":[{"name":"COPSAC, Copenhagen Prospective Studies on Asthma in Childhood Copenhagen University Hospital, Herlev\u2010Gentofte  Copenhagen Denmark"},{"name":"Department of Pediatrics Copenhagen University Hospital \u2013 N\u00e6stved, Slagelse and Ringsted  Slagelse Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6383-8845","authenticated-orcid":false,"given":"Nicklas","family":"Brustad","sequence":"additional","affiliation":[{"name":"COPSAC, Copenhagen Prospective Studies on Asthma in Childhood Copenhagen University Hospital, Herlev\u2010Gentofte  Copenhagen Denmark"},{"name":"Department of Biomedical Sciences Faculty of Health and Medical Sciences, University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2540-5373","authenticated-orcid":false,"given":"Casper\u2010Emil Tingskov","family":"Pedersen","sequence":"additional","affiliation":[{"name":"COPSAC, Copenhagen Prospective Studies on Asthma in Childhood Copenhagen University Hospital, Herlev\u2010Gentofte  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anton","family":"Kjellberg","sequence":"additional","affiliation":[{"name":"COPSAC, Copenhagen Prospective Studies on Asthma in Childhood Copenhagen University Hospital, Herlev\u2010Gentofte  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4812-980X","authenticated-orcid":false,"given":"Thea K.","family":"Fischer","sequence":"additional","affiliation":[{"name":"Department of Clinical Research Nordsj\u00e6llands Hospital  Hiller\u00f8d Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7536-3453","authenticated-orcid":false,"given":"Karen A.","family":"Krogfelt","sequence":"additional","affiliation":[{"name":"Institute for Science and Environment Roskilde University  Roskilde Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3604-2602","authenticated-orcid":false,"given":"Nilo","family":"Vahman","sequence":"additional","affiliation":[{"name":"COPSAC, Copenhagen Prospective Studies on Asthma in Childhood Copenhagen University Hospital, Herlev\u2010Gentofte  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6667-4708","authenticated-orcid":false,"given":"James E.","family":"Gern","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Medicine University of Wisconsin\u2010Madison  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5827-0885","authenticated-orcid":false,"given":"Ann\u2010Marie Malby","family":"Schoos","sequence":"additional","affiliation":[{"name":"COPSAC, Copenhagen Prospective Studies on Asthma in Childhood Copenhagen University Hospital, Herlev\u2010Gentofte  Copenhagen Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"},{"name":"Department of Pediatrics Copenhagen University Hospital \u2013 N\u00e6stved, Slagelse and Ringsted  Slagelse Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2003-1018","authenticated-orcid":false,"given":"Klaus","family":"B\u00f8nnelykke","sequence":"additional","affiliation":[{"name":"COPSAC, Copenhagen 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