Article
Natural history of respiratory infections during the first six years of life – results from the prospective birth cohort study LoewenKIDS
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Authors
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Bianca Klee
- Institut für Med. Epidemiologie, Biometrie und Informatik, Med. Fakultät der Martin-Luther-Univsersität Halle-Wittenberg, Halle (Saale), Germany
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Sophie Diexer
- Institut für Med. Epidemiologie, Biometrie und Informatik, Med. Fakultät der Martin-Luther-Univsersität Halle-Wittenberg, Halle (Saale), Germany
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Susan Langer
- Institut für Med. Epidemiologie, Biometrie und Informatik, Med. Fakultät der Martin-Luther-Univsersität Halle-Wittenberg, Halle (Saale), Germany
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Cornelia Gottschick
- Institut für Med. Epidemiologie, Biometrie und Informatik, Med. Fakultät der Martin-Luther-Univsersität Halle-Wittenberg, Halle (Saale), Germany
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Rafael Mikolajczyk
- Institut für Med. Epidemiologie, Biometrie und Informatik, Med. Fakultät der Martin-Luther-Univsersität Halle-Wittenberg, Halle (Saale), Germany
| Published: | September 6, 2024 |
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Outline
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Introduction: Acute respiratory infections (ARI) often occur in early childhood and are mostly self-limiting, but they cause a high socioeconomic burden and can be associated with chronic diseases in later life. ARI are mostly assessed in hospital- or registry-based-studies, which neglect the burden of non-medically attended ARI. Prospective birth cohort studies using symptom diaries are a valuable method to assess the burden of ARI in real time and can provide estimates on the number of ARI to be expected during childhood. In this study, we aim to describe the natural history of ARI during the first six years of life.
Methods: We used data from the LoewenKIDS birth cohort study which includes 782 children born between 2014 and 2018 and followed until the age of six (parents of 372 children participated actively until the age of six). Parents were asked to record respiratory symptoms in a symptom diary, provide nasal swabs in case of an infection and to complete annual structured questionnaires. Respiratory symptoms were classified into ARI episodes, which were defined as one or more category A symptoms (fever, wheezing, cough with sputum) or two or more category B symptoms (runny nose, nasal congestion, sore throat, cough, chills, loss of appetite, increased need to sleep, increased attachment). We selected participants who completed at least 80% days of the symptom diary from birth to the age of six years.
Results: A total of 258 children (69% of children who actively participated until their 6th birthday) were included in the analysis. The mean number of ARI recorded in the diary in the first six years of life was 31.9 (95% Confidence Interval (CI): 30.3-33.5 ARI). The mean annual number of ARI increased from year 1 (mean: 6.3 ARI) to year 2 (mean: 8.2 ARI) and declined in the following years (mean 3rd year: 6.4 ARI; mean 4th year: 4.7 ARI; mean 5th year: 4.3; mean 6th year: 4.1 ARI). ARI lasted on average 11.3 days (95%CI: 10.9-11.6 days), with only minor variations by age. The mean cumulative duration of ARI up to six years was 51.5 weeks (95% CI 47.5-55.6 weeks). During most ARI the following symptoms were present: runny nose (77% of all ARI), cough (65%) and increased attachment (56%). ARI episodes were more frequent during the autumn/winter period although this pattern was less pronounced during the COVID-19 pandemic. Children who had experienced frequent ARI episodes (highest tercile) during infancy (aged 1-2 years) continued to have more infections during the pre-school age (aged 5-6 years).
Conclusion: ARI are very common during the first six years of life. Higher susceptibility from the first two years continues during childhood.
The authors declare that they have no competing interests.
The authors declare that a positive ethics committee vote has been obtained.
