Childhood lower respiratory infections linked to early death


March 11, 2023 | 3:01 p.m

Children who contract lower respiratory tract infection (LRTI) at two years of age or younger may be more likely to die prematurely from the same condition as adults, a new study has found.

These types of infections have been linked to a fifth of deaths.

The new study was conducted by a group of researchers from London and led by Dr. James Peter Allinson of the National Heart and Lung Institute at Imperial College London. It was published in The Lancet this week.

It analyzed data from the National Health and Development Medical Research Council, which followed 3,589 participants in England, Scotland and Wales all born in March 1946.

LRTIs are infections that impact the airways, including bronchitis, bronchiolitis, influenza, and pneumonia.

Researchers identified individuals who developed LRTI before their second birthday—based on reports from parents or guardians—then looked at public health records to determine those who died of respiratory disease among the age from 26 to 73.

Participants were also contacted 25 times during the eight-decade study.

Children who contract lower respiratory tract infections at two years of age or younger may be more likely to die prematurely from the same condition as adults.
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After adjusting for socioeconomic status, gender, smoking habits, family size, birth weight and other factors, the researchers found that participants who developed an LRTI as a children were 93% more likely to die of respiratory disease at age 73.

Dr. Purvi Parikh, an allergist and immunologist based in New York with Allergy & Asthma Associates, was not involved in the study, but said he was not surprised by the results.

“We already have data that respiratory viruses early in life can sensitize the airways and predispose children to develop asthma and COPD when they are older,” he told Fox News Digital in an email.

Study participants who developed an LRTI as a child were 93% more likely to die from the respiratory disease at age 73.
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Before the age of 2 years, he said, the lungs are still developing, as is the immune system.

“Damage to the lungs and airways during this time frame can have lasting effects on lung tissue, including scarring and inflammation, and can also impact the immune system,” he said.

The most common cause of respiratory death was chronic obstructive pulmonary disease (COPD), followed by acute lower respiratory tract infection, interstitial lung disease, bronchiectasis, respiratory disease due to external agents and other respiratory diseases, the results said.

The researchers wrote that infection during childhood could result in impaired lung function during adulthood – leading to a higher chance of respiratory disease.

Smoking caused an increased risk for respiratory diseases in adulthood.
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The study had some limitations

The authors of the study admit that, like all population survival studies, this one had some limitations and built-in biases.

“Even if we adjusted for important socio-economic factors and smoking, some adverse exposures remained unrecognized, and therefore unrecorded, in the 1940s,” they wrote.

“Prospective investigation of unrecorded factors, including parental smoking and prematurity, awaits the maturation of studies initiated later.”

The lead author, Dr. James Allinson, said that when the study began, there were probably more inequalities in health care among a generation that has now reached adulthood.

“During their lifetimes, average living conditions and health care in high-income countries (such as the United States and the United Kingdom) have improved markedly,” he said. “Therefore, children born today in these countries can be on course to develop better adult health.”

However, Dr. Allinson added that there are still cases of inequity and poverty, even in high-income countries.

“Our data are likely to be highly relevant for children born in many low- and middle-income countries,” he said.

Adults who have had lower respiratory infections as children are more likely to develop asthma.
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Opportunity to break the cycle

Dr. Allison said that current preventive measures for adult respiratory disease mainly focus on adult lifestyle risk factors, such as smoking.

“Linking one in five adult respiratory deaths to common infections several decades earlier in childhood shows the need to address the risk well before adulthood,” he told Fox News Digital in an email.

“To prevent the perpetuation of existing adult health inequalities, we need to optimize childhood health,” continued the doctor.

“Showing the early life origins of chronic diseases in adults also helps challenge the smoking-related stigma attached to death from diseases such as COPD.”

Ultimately, Dr. Parikh said the study highlights the importance of the early years of development in determining lifelong health. She recommends preventing lower respiratory tract infections by administering vaccines during infancy.

“An RSV vaccine may be approved soon that an expectant mother could take during the third trimester to prevent this virus from causing severe disease in the newborn,” he said.

(Pfizer plans to get approval to launch their RSV vaccine in the United States and Europe in the fall, Reuters reported on Thursday.)

Meanwhile, Dr. Parikh stressed the importance of vaccination for children against pneumonia, influenza, COVID and pertussis to help prevent infectious diseases.

The lead author, Dr. Allinson, also stressed the need for governments to address factors that put childhood respiratory health at risk, including childhood exposure to pollution or cigarette smoke, housing of poor quality, poor nutrition and inadequate health care provision.

“Many of these factors are closely related to social disadvantage and poverty,” he said.

While minor respiratory infections are common in childhood, the doctor warned that chronic or recurring symptoms can indicate underlying health problems, such as asthma – which should be diagnosed and treated appropriately.

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