Respiratory tract infections in young children are associated with an increased risk of asthma and worsening lung function later in life, according to new European research.
In an international study of one hundred and fifty-four thousand, four hundred and ninety-two children, it was found that those who had had upper respiratory tract infections, such as colds, sinusitis, laryngitis, tonsillitis, pharyngitis, and otitis media, by the age of five years, had a 1.5-fold increase in the risk of developing asthma later in life. Children who had lower respiratory tract infections such as bronchitis, bronchiolitis , pneumonia, and common chest infections were twice as likely to develop asthma and were also more likely to have worse lung function.
The researchers from the Netherlands noted that their results support the hypothesis that early respiratory tract infections may influence the development of respiratory diseases and, in particular, early lower respiratory tract infections seem to have the greatest negative impact on function. lungs and the risk of developing asthma. However, at this stage it is impossible to say for sure whether the relationship is causal. Further studies that measure lung function and breathing parameters from birth are needed to investigate whether infections are the cause of asthma and lower lung function. Research aimed at preventing or treating respiratory tract infections at an early stage, possibly through vaccination, will also shed light on this issue. Lung function and asthma are only partially related, the authors say. Lung function may be affected without affecting symptoms, or it may lead to asthma or other complaints such as wheezing. In addition, the child may be diagnosed with asthma, and lung function may change slightly, for example, because the patient is taking asthma medication, the authors note. The researchers analyzed data from thirty-seven groups of children from several European countries born between 1989 and 2013. Children were included in this meta-analysis if data were available for early respiratory tract infections (6 months to 5 years) and for asthma or impaired lung function. The length of follow-up varied between groups, but ranged from birth to 4-15 years of age. The children’s lung function was measured as they got older using a spirometer. Parameters such as
a measure of the amount of air that a person can exhale after the maximum possible inspiration (FVC), the volume of exhalation in one second (FEV1), the speed of exhaled air after exhaling three-quarters of the total lung volume during forced exhalation (FEF75) were noted. children, lung function was not measured, the youngest children whose breathing parameters were assessed were at the age of four years, and the oldest at fifteen. The median age was eight years. The researchers adjusted parameters for factors that may affect the results, such as socioeconomic status, lifestyle, birth weight, gestational age at birth, gender, age, height, and ethnicity. They found that upper respiratory tract infections were not associated with worse lung function later in life. However, lower respiratory tract infections at nearly all ages have been associated with worse lung function, as shown by lower FVC, FEV1, and FEF75.
The authors believe that it will be interesting to study the long-term effects in adulthood of respiratory tract infections on lung function and asthma. Lung function in childhood is most likely related to lung function in adulthood. Going forward, the scientists want to study the roles of antibiotics, paracetamol and smoke exposure in the relationship between respiratory tract infections and lung function or asthma. They also plan to clarify what percentage of the association between respiratory tract infections and asthma can be explained by changes in lung function, and whether the association changes when early wheezing is taken into account.