Impact of Early‑Life Rhinovirus and Respiratory Syncytial Virus Infections on Recurrent Wheeze and Asthma Development

ABSTRACT
Early‑life viral lower respiratory tract infections (LRTIs), particularly those due to rhinovirus (RV) and respiratory syncytial virus (RSV), play a pivotal role in the developmental origins of pediatric respiratory disease. RV and RSV are among the most prevalent causes of bronchiolitis and early wheezing globally. Longitudinal evidence and mechanistic studies have increasingly shown that these infections do not merely cause acute morbidity but also set the stage for chronic airway inflammation, wheeze, and asthma. Notably, new cohort data (INSPIRE study, and other European birth cohorts) and reviews from 2025 by Hartert and Zar build on this paradigm and reinforce the need to understand early viral exposures as critical modifiers of airway trajectory. This narrative review draws on recent epidemiologic, mechanistic, and interventional evidence, supplemented with recent findings, to detail how RV and RSV exposures in infancy contribute to lasting respiratory morbidity.

Received: Jul 25, 2025
Accepted: Oct 09, 2025
Published: Apr 02, 2026