TY - JOUR
T1 - Time-Varying Association Between Severe Respiratory Syncytial Virus Infections and Subsequent Severe Asthma and Wheeze and Influences of Age at the Infection
AU - Wang, Xin
AU - Li, You
AU - Nair, Harish
AU - Campbell, Harry
AU - Reeves, Rachel M.
AU - van Wijhe, Maarten
AU - Fischer, Thea Kølsen
AU - Simonsen, Lone
AU - Trebbien, Ramona
AU - Tong, Sabine
AU - Bangert, Mathieu
AU - Demont, Clarisse
AU - Lehtonen, Toni
AU - Heikkinen, Terho
AU - Teirlinck, Anne
AU - van Boven, Michiel
AU - van der Hoek, Wim
AU - van der Maas, Nicoline
AU - Meijer, Adam
AU - Fernandez, Liliana Vazquez
AU - Bøas, Håkon
AU - Bekkevold, Terese
AU - Flem, Elmira
AU - Stona, Luca
AU - Speltra, Irene
AU - Giaquinto, Carlo
AU - Cheret, Arnaud
AU - Leach, Amanda
AU - Stoszek, Sonia
AU - Beutels, Philippe
AU - Bont, Louis
AU - Pollard, Andrew
AU - Openshaw, Peter
AU - Abram, Michael
AU - Swanson, Kena
AU - Rosen, Brian
AU - Molero, Eva
N1 - Publisher Copyright:
© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved.
PY - 2022/8/1
Y1 - 2022/8/1
N2 - Background. Early-life severe respiratory syncytial virus (RSV) infection has been associated with subsequent risk of asthma and recurrent wheeze. However, changes in the association over time and the interaction effect of the age at first RSV infection are less well understood. We aimed to assess the time-varying association between RSV and subsequent asthma and wheeze admission and explore how the association was affected by the age at RSV infection. Methods. We retrospectively followed up a cohort of 23 365 children for a median of 6.9 years using Scottish health databases. Children who were born between 2001 and 2013 and had RSV-associated respiratory tract infection (RTI) admissions under 2 years were in the exposed group; those with unintentional accident admissions under 2 years comprised the control group. The Cox proportional-hazards model was used to report adjusted hazard ratios (HRs) of RSV admissions on subsequent asthma and wheeze admissions. We did subgroup analyses by follow-up years. We also explored how this association was affected by the age at first RSV admission. Results. The association was strongest in the first 2 years of follow-up and decreased over time. The association persisted for 6 years in children whose first RSV-RTI admission occurred at 6-23 months of age, with an adjusted HR of 3.9 (95% confidence interval [CI], 3.1-4.9) for the first 2 years, 2.3 (95% CI, 1.6-3.2) for 2 to <4 years, and 1.9 (95% CI, 1.2-2.9) for 4 to <6 years of follow-up. In contrast, the association was only significant for the first 2 years after first RSV-RTI admissions occurring at 0-5 months. Conclusions. We found a more persistent association for subsequent asthma and wheeze in children whose first severe RSV infection occurred at 6-23 months compared to those whose first severe RSV infection occurred at 0-6 months. This provides new evidence for further assessment of the association and RSV intervention programs.
AB - Background. Early-life severe respiratory syncytial virus (RSV) infection has been associated with subsequent risk of asthma and recurrent wheeze. However, changes in the association over time and the interaction effect of the age at first RSV infection are less well understood. We aimed to assess the time-varying association between RSV and subsequent asthma and wheeze admission and explore how the association was affected by the age at RSV infection. Methods. We retrospectively followed up a cohort of 23 365 children for a median of 6.9 years using Scottish health databases. Children who were born between 2001 and 2013 and had RSV-associated respiratory tract infection (RTI) admissions under 2 years were in the exposed group; those with unintentional accident admissions under 2 years comprised the control group. The Cox proportional-hazards model was used to report adjusted hazard ratios (HRs) of RSV admissions on subsequent asthma and wheeze admissions. We did subgroup analyses by follow-up years. We also explored how this association was affected by the age at first RSV admission. Results. The association was strongest in the first 2 years of follow-up and decreased over time. The association persisted for 6 years in children whose first RSV-RTI admission occurred at 6-23 months of age, with an adjusted HR of 3.9 (95% confidence interval [CI], 3.1-4.9) for the first 2 years, 2.3 (95% CI, 1.6-3.2) for 2 to <4 years, and 1.9 (95% CI, 1.2-2.9) for 4 to <6 years of follow-up. In contrast, the association was only significant for the first 2 years after first RSV-RTI admissions occurring at 0-5 months. Conclusions. We found a more persistent association for subsequent asthma and wheeze in children whose first severe RSV infection occurred at 6-23 months compared to those whose first severe RSV infection occurred at 0-6 months. This provides new evidence for further assessment of the association and RSV intervention programs.
KW - age at first RSV infection
KW - asthma
KW - severe RSV infections
KW - time since RSV infection
KW - wheeze
UR - https://www.scopus.com/pages/publications/85136340992
U2 - 10.1093/infdis/jiab308
DO - 10.1093/infdis/jiab308
M3 - Article
C2 - 34522963
AN - SCOPUS:85136340992
SN - 0022-1899
VL - 226
SP - S38-S44
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - Suppl_1
ER -