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Childhood LRTI linked to nearly two-fold higher risk of premature adult respiratory-related death

17th March 2023

A childhood lower respiratory tract infection (LRTI) nearly doubles the risk of a premature adult respiratory-related death according to the findings of a life-spanning cohort study by UK researchers.

Chronic respiratory diseases are a leading cause of death and disability worldwide and in 2017, represented the third largest cause of mortality. Moreover, adverse factors affecting lung development during foetal life as well as in early childhood, decrease the attainment of maximal lung function and accelerate function decline in adulthood. Although researchers have speculated for some time that there is a direct casual link between acute lower respiratory infection in early childhood and conditions such as chronic bronchitis in adult life, an absence of longitudinal data, makes it difficult to provide greater clarity on the relationship between childhood respiratory infections and possible early deaths from a respiratory cause.

In the current study, researchers prospectively collected data from a nationally representative cohort of all single births among married women during 1 week in March, 1946, across England, Scotland and Wales with a review to evaluating the association between the presence of a LRTI during early childhood (age < 2 years) and death from respiratory disease from age 26 through 73 years.

Childhood LRTI and premature respiratory-related death

Researchers included a total of 3,589 participants, aged 26 years (51% male) and who were included in the analysis from 1972 onwards and followed-up for a median of 47.9 years.

After adjusting for several factors including adult smoking, among these 3,589 participants, 25% had an LRTI during early childhood, which nearly doubled their risk of premature death from a respiratory-related disease by age 73 (Hazard Ratio, HR = 1.93, 95% CI 1.10 – 3.37, p = 0.021). Furthermore, in subgroup analysis, there was no evidence that an early childhood LRTI increased the risk of circulatory, cancer, external, other-cause, or all-cause mortality.

The researchers also calculated that the population attributable risk of premature adult death from respiratory disease due to early childhood LRTI was 20·4% and which corresponded to an estimated 179, 188 excess and premature adult deaths across England and Wales between 1972 and 2019.

The authors concluded that a LRTI during early childhood was associated with almost a two times increased risk of premature adult death from respiratory disease and that it accounted for a fifth of all these deaths.

Allinson JP et al. Early childhood lower respiratory tract infection and premature adult death from respiratory disease in Great Britain: a national birth cohort study. Lancet 2023