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Early-life respiratory tract infections and the risk of school-age lower lung function and asthma: a meta-analysis of 150 000 European children

Early-life respiratory tract infections and the risk of school-age lower lung function and asthma: a meta-analysis of 150 000 European children
Early-life respiratory tract infections and the risk of school-age lower lung function and asthma: a meta-analysis of 150 000 European children
Background: early-life respiratory tract infections might affect chronic obstructive respiratory diseases, but conclusive studies from general populations are lacking. Our objective was to examine if children with early-life respiratory tract infections had increased risks of lower lung function and asthma at school age.

Methods: we used individual participant data of 150 090 children primarily from the EU Child Cohort Network to examine the associations of upper and lower respiratory tract infections from age 6 months to 5 years with forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC, forced expiratory flow at 75% of FVC (FEF75%) and asthma at a median (range) age of 7 (4–15) years.

Results: children with early-life lower, not upper, respiratory tract infections had a lower school-age FEV1, FEV1/FVC and FEF75% (z-score range: −0.09 (95% CI −0.14– −0.04) to −0.30 (95% CI −0.36– −0.24)). Children with early-life lower respiratory tract infections had a higher increased risk of school-age asthma than those with upper respiratory tract infections (OR range: 2.10 (95% CI 1.98–2.22) to 6.30 (95% CI 5.64–7.04) and 1.25 (95% CI 1.18–1.32) to 1.55 (95% CI 1.47–1.65), respectively). Adjustment for preceding respiratory tract infections slightly decreased the strength of the effects. Observed associations were similar for those with and without early-life wheezing as a proxy for early-life asthma.

Conclusions: our findings suggest that early-life respiratory tract infections affect development of chronic obstructive respiratory diseases in later life, with the strongest effects for lower respiratory tract infections.
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van Meel, Evelien R.
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et al.
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van Meel, Evelien R., Mensink-Bout, Sara M. and den Dekker, Herman T. , et al. (2022) Early-life respiratory tract infections and the risk of school-age lower lung function and asthma: a meta-analysis of 150 000 European children. The European respiratory journal, 60 (4), [2102395]. (doi:10.1183/13993003.02395-2021).

Record type: Article

Abstract

Background: early-life respiratory tract infections might affect chronic obstructive respiratory diseases, but conclusive studies from general populations are lacking. Our objective was to examine if children with early-life respiratory tract infections had increased risks of lower lung function and asthma at school age.

Methods: we used individual participant data of 150 090 children primarily from the EU Child Cohort Network to examine the associations of upper and lower respiratory tract infections from age 6 months to 5 years with forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC, forced expiratory flow at 75% of FVC (FEF75%) and asthma at a median (range) age of 7 (4–15) years.

Results: children with early-life lower, not upper, respiratory tract infections had a lower school-age FEV1, FEV1/FVC and FEF75% (z-score range: −0.09 (95% CI −0.14– −0.04) to −0.30 (95% CI −0.36– −0.24)). Children with early-life lower respiratory tract infections had a higher increased risk of school-age asthma than those with upper respiratory tract infections (OR range: 2.10 (95% CI 1.98–2.22) to 6.30 (95% CI 5.64–7.04) and 1.25 (95% CI 1.18–1.32) to 1.55 (95% CI 1.47–1.65), respectively). Adjustment for preceding respiratory tract infections slightly decreased the strength of the effects. Observed associations were similar for those with and without early-life wheezing as a proxy for early-life asthma.

Conclusions: our findings suggest that early-life respiratory tract infections affect development of chronic obstructive respiratory diseases in later life, with the strongest effects for lower respiratory tract infections.

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Accepted/In Press date: 9 March 2022
e-pub ahead of print date: 6 October 2022
Additional Information: Funding Information: Conflict of interest: T.S. Ahluwalia received funding for the current manuscript from the Novo Nordisk Foundation (NNF180C0052457). I. Annesi-Maesano is member of the ATS Environment Health Policy Committee, the ERS Ethics and Integrity Committee, and the French IRD Ethics Committee. S.H. Arshad received funding for the manuscript from Asthma UK (364) and National Institutes of Health USA (R01HL082925). H. Bisgaard received funding for the current manuscript from the Lundbeck Foundation (R16-A1694), Ministry of Health (903516), Danish Council for Strategic Research (0603-00280B) and Capital Region Research Foundation. M. Eggesbø received paid honorarium for making small videos relating to allergy and asthma, by the Norwegian LHL organisation. U. Frey received funding for the manuscript from the Swiss National Science Foundation (320030_204717/1), and is chair of the National Steering Board, Swiss Personalized Health Network (SPHN). H. Inskip received funding for the manuscript from the UK Medical Research Council and the European Union, and was President for the Society for Social Medicine and Population Health. J. Jerzynska received funding for the current manuscript from the National Science Centre, Poland (DEC-2014/15/B/N27/00998). A.M. Karvonen received funding for the present manuscript from the Academy of Finland (139021, 287675, 296814, 296817, 308254), Juho Vainio Foundation, EVO/VTR funding, Pavivikki and Sakari Sohlberg Foundation, Farmers’ Social Insurance Institution (Mela), Finnish Cultural Foundation, Foundation for Pediatric Research, and the European Union (QLK4-CT-2001-0250). M. Mommers received grants from the Research Council of Norway (262700) and European Research Council (947684). A. Pinot de Moira received a Lundbeck Foundation fellowship (R264-2017-3099). V. Peltola received funding for the present manuscript from the Academy of Finland and Foundation for Pediatric Research Finland. K.C. Pike received consulting fees from Novartis and Spiriva, payment or honoraria for lectures from Novartis, and is participating on a data safety monitoring board or advisory board for Adherium. K. Polanska received funding for the current manuscript from the National Science Centre, Poland (DEC-2014/15/B/N27/00998), grant PRNF-218-AI-1/07 from Norway through the Norwegian Financial Mechanisms within the Polish–Norwegian Research Fund, and the Ministry of Science and Higher Education, Poland (PBZ-MEiN-/8/2//2006). G. Roberts is president of the BSACI. A.C. Santos received funding for the current manuscript from FCT Investigators contracts (IF/01060/2015). J. Sunyer received a grant from the European Research Council (Prenatal exposure to urban AIR pollution and pre-and postNatal Brain development (AIR-NB), 785994). J. Usemann received grants from the Palatin Foundation, University of Basel Switzerland, Swiss Cancer League and Swiss Lung Foundation, and payments or honoraria for lectures from Vertex and Zurich Lung Foundation. V.W.V. Jaddoe received a grant from the European Research Council (ERC-2014-CoG-648916). L. Duijts received funding from cofunded ERA-Net on Biomarkers for Nutrition and Health (ERA HDHL), Horizon 2020 (696295; 2017), the Netherlands Organisation for Health Research and Development (ZonMw; 529051014; 2017), Science Foundation Ireland (SFI/16/ERA-HDHL/3360), and the European Union (ALPHABET project). All other authors declare no conflict of interest. Funding Information: Conflict of interest: T.S. Ahluwalia received funding for the current manuscript from the Novo Nordisk Foundation (NNF180C0052457). I. Annesi-Maesano is member of the ATS Environment Health Policy Committee, the ERS Ethics and Integrity Committee, and the French IRD Ethics Committee. S.H. Arshad received funding for the manuscript from Asthma UK (364) and National Institutes of Health USA (R01HL082925). H. Bisgaard received funding for the current manuscript from the Lundbeck Foundation (R16-A1694), Ministry of Health (903516), Danish Council for Strategic Research (0603-00280B) and Capital Region Research Foundation. M. Eggesbø received paid honorarium for making small videos relating to allergy and asthma, by the Norwegian LHL organisation. U. Frey received funding for the manuscript from the Swiss National Science Foundation (320030_204717/1), and is chair of the National Steering Board, Swiss Personalized Health Network (SPHN). H. Inskip received funding for the manuscript from the UK Medical Research Council and the European Union, and was President for the Society for Social Medicine and Population Health. J. Jerzynska received funding for the current manuscript from the National Science Centre, Poland (DEC-2014/15/B/N27/00998). A.M. Karvonen received funding for the present manuscript from the Academy of Finland (139021, 287675, 296814, 296817, 308254), Juho Vainio Foundation, EVO/VTR funding, Pavivikki and Sakari Sohlberg Foundation, Farmers’ Social Insurance Institution (Mela), Finnish Cultural Foundation, Foundation for Pediatric Research, and the European Union (QLK4-CT-2001-0250). M. Mommers received grants from the Research Council of Norway (262700) and European Research Council (947684). A. Pinot de Moira received a Lundbeck Foundation fellowship (R264-2017-3099). V. Peltola received funding for the present manuscript from the Academy of Finland and Foundation for Pediatric Research Finland. K.C. Pike received consulting fees from Novartis and Spiriva, payment or honoraria for lectures from Novartis, and is participating on a data safety monitoring board or advisory board for Adherium. K. Polanska received funding for the current manuscript from the National Science Centre, Poland (DEC-2014/15/B/N27/00998), grant PRNF-218-AI-1/07 from Norway through the Norwegian Financial Mechanisms within the Polish–Norwegian Research Fund, and the Ministry of Science and Higher Education, Poland (PBZ-MEiN-/8/2//2006). G. Roberts is president of the BSACI. A.C. Santos received funding for the current manuscript from FCT Investigators contracts (IF/01060/2015). J. Sunyer received a grant from the European Research Council (Prenatal exposure to urban AIR pollution and pre- and postNatal Brain development (AIR-NB), 785994). J. Usemann received grants from the Palatin Foundation, University of Basel Switzerland, Swiss Cancer League and Swiss Lung Foundation, and payments or honoraria for lectures from Vertex and Zurich Lung Foundation. V.W.V. Jaddoe received a grant from the European Research Council (ERC-2014-CoG-648916). L. Duijts received funding from cofunded ERA-Net on Biomarkers for Nutrition and Health (ERA HDHL), Horizon 2020 (696295; 2017), the Netherlands Organisation for Health Research and Development (ZonMw; 529051014; 2017), Science Foundation Ireland (SFI/16/ERA-HDHL/3360), and the European Union (ALPHABET project). All other authors declare no conflict of interest. Publisher Copyright: © 2022 European Respiratory Society. All rights reserved.

Identifiers

Local EPrints ID: 457334
URI: http://eprints.soton.ac.uk/id/eprint/457334
ISSN: 0903-1936
PURE UUID: d06b1038-4500-4b7d-ac13-42f8eaaa9767
ORCID for Hazel Inskip: ORCID iD orcid.org/0000-0001-8897-1749
ORCID for Graham Roberts: ORCID iD orcid.org/0000-0003-2252-1248

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Date deposited: 01 Jun 2022 16:42
Last modified: 17 Apr 2024 01:39

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Contributors

Author: Evelien R. van Meel
Author: Sara M. Mensink-Bout
Author: Herman T. den Dekker
Author: Tarunveer S. Ahluwalia
Author: Isabella Annesi-Maesano
Author: Nour Baïz
Author: Henrique Barros
Author: Andrea von Berg
Author: Hans Bisgaard
Author: Klaus Bønnelykke
Author: Christian J. Carlsson
Author: Maribel Casas
Author: Leda Chatzi
Author: Cecile Chevrier
Author: Geertje Dalmeijer
Author: Carol Dezateux
Author: Karel Duchen
Author: Merete Eggesbø
Author: Cornelis van der Ent
Author: Maria Fantini
Author: Claudia Flexeder
Author: Urs Frey
Author: Fransesco Forastiere
Author: Ulrike Gehring
Author: Davide Gori
Author: Raquel Granell
Author: Lucy J. Griffiths
Author: Hazel Inskip ORCID iD
Author: Joanna Jerzynska
Author: Anne M. Karvonen
Author: Thomas Keil
Author: Cecily Kelleher
Author: Manolis Kogevinas
Author: Gudrun Koppen
Author: Claudia E. Kuehni
Author: Nathalie Lambrechts
Author: Susanne Lau
Author: Irina Lehmann
Author: Johnny Ludvigsson
Author: Maria Christine Magnus
Author: Erik Mélen
Author: John Mehegan
Author: Monique Mommers
Author: Anne-Marie Nybo Andersen
Author: Wenche Nystad
Author: Eva S.L. Pedersen
Author: Juha Pekkanen
Author: Ville Peltola
Author: Graham Roberts ORCID iD
Corporate Author: et al.

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