Respiratory virus prevalence is higher in acute asthma than stable asthma across children and adults.
This systematic review and meta-analysis evaluated the prevalence of respiratory viruses in patients with asthma. The pooled dataset included 111 eligible studies covering both children and adults. The primary outcome measured was the prevalence of any respiratory virus, with secondary analyses focusing on rhinovirus in acute settings.
In patients with stable asthma, the pooled prevalence of any respiratory virus was 33.9% (95% CI 24.8-43.7%) in children and 23.0% (95% CI 12.9-35.0%) in adults. During acute asthma episodes, prevalence increased to 58.8% (95% CI 52.5-65.0%) in children and 49.9% (95% CI 41.2-58.5%) in adults. Specifically, rhinovirus prevalence was 45.0% in children and 21.2% in adults with acute asthma.
No specific safety data, adverse events, or tolerability information were reported in the included studies. The evidence is classified as moderate-certainty. A key limitation is that the setting was not reported for the individual studies, and no specific comparator group was defined beyond the stable vs. acute distinction. The authors note that the diagnostic value of a positive viral test during acute episodes may be limited.
To improve clinical interpretation, complementary biomarkers may be beneficial. The evidence suggests a potential association with more severe acute attacks, but causal links cannot be established from this observational synthesis. Clinicians should consider these prevalence rates when evaluating respiratory symptoms but avoid overreliance on viral testing alone for diagnosis.
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