Daily Dose: RSV LRTI in Infancy Linked to More Clinical, Pulmonary Function Sequelae


Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

On June 7, 2023, we reported on a study published in BMJ Open Respiratory Research that described the clinical and pulmonary function sequelae through to 2 years of age in infants who were hospitalized for respiratory syncytial virus (RSV) with lower respiratory tract infection (LRTI) and matched controls.

The study

The study was conducted at a secondary-tertiary-level hospital in Johannesburg, South Africa, from April 1, 2016, to December 31, 2019. Researchers included infants hospitalized for severe or very severe RSV LRTI (defined as “cases”) and a control group of healthy term infants not hospitalized with an LRTI in the first year of life. The control group was matched 1:1 with cases for sex and chronological age at the time of pulmonary function testing.

Investigators administered a questionnaire detailing environmental and medical history, along with a modified International Study of Asthma and Allergies questionnaire. Also, pulmonary function testing—including oscillometry, tidal breath flow-volume loops, and multiple breath wash-out—was performed at 1 and 2 years of age.

The findings

Researchers identified 964 hospitalized RSV cases (ie, infants hospitalized with RSV LRTI). There were 308 1-year-old (57% boys, median age 12.4 months) and 214 2-year-old (54% boys, median age 24.6 months) cases for study inclusion. The matched control group included 292 infants aged 1 year (53% boys; median age 12.5 months) and 209 infants aged 2 years (46% boys; median age 23.9 months).

By 1 year of age, infants in the cases group compared with the control group had increased odds of wheezing or whistling in the chest (adjusted odds ratio [aOR], 2.78, 95% CI 1.75-4.44), hospitalization for wheezing or whistling in the chest (aOR, 5.66, 95% CI 3.17-10.09), or for any LRTI (aOR, 10.43, 95% CI 4.39-24.77), and of receiving treatment for wheezing or whistling in the chest (aOR, 3.05, 95% CI, 1.70-5.47).

In addition, cases compared with controls were more likely to have reported sleep disturbance due to wheezing or whistling in the chest (aOR 8.36, 95% CI 5.42-12.90) and to have a dry cough at night (aOR 4.37, 95% CI 3.02-6.33) by age 1.

Between 1 and 2 years of age, cases remained more likely to experience wheezing or whistling in the chest (aOR 8.11, 95% CI 5.04-13.04), to be hospitalized for wheezing or whistling in the chest (aOR 58.08, 95% CI 17.98-187.59) or an LRTI (aOR 33.89, 95% CI 10.35-110.96), and to have received treatment for wheezing or whistling in the chest (aOR 21.11, 95% CI 10.76-41.45).

Clinical implications

"This study adds valuable data describing early life pulmonary sequelae after RSV LRTI. Further research is needed to better delineate the long-term effects of RSV LRTI on the developing lung as well as research describing contributory factors, such as genetic, environmental and socioeconomic, and the impact on lung function trajectories."

Click here for more details.

Related Videos
Tezepelumab Significantly Reduced Exacerbations in Patients with Severe Asthma, Respiratory Comorbidities
Related Content
© 2023 MJH Life Sciences

All rights reserved.