Understanding recurrent wheezing: A parent's guide

Recurrent wheezing following acute lower respiratory tract infection (ALRTI) in early childhood is a common clinical problem and may be an early indicator of chronic respiratory diseases. Early identification of associated risk factors is essential for early intervention and prevention.

To investigate the risk factors and timing of recurrent wheezing episodes following ALRTI in children.

A retrospective cohort study was conducted among pediatric patients ≤ 5 years old admitted with ALRTI and wheezing at Naresuan University Hospital between July 1, 2020 and June 30, 2023. Participants were followed for 12 months. Data from electronic and paper records were analyzed using STATA 18.0. Multivariable logistic regression identified independent risk factors. Kaplan-Meier analysis and log-rank tests compared recurrence and non-recurrence groups through survival curves.

Significant predictors of recurrent wheezing included age 12-24 months [odds ratio (OR): 2.38; 95%CI: 1.50-3.78, P < 0.001], prematurity (OR: 1.66; 95%CI: 1.07-2.58, P = 0.024), allergic rhinitis (OR: 1.50; 95%CI: 1.04-2.17, P = 0.031), urban residency (OR: 1.68; 95%CI: 1.19-2.38, P = 0.003), eosinophilia (absolute eosinophil count > 500 cells/μL) (OR: 3.29; 95%CI: 1.57-6.91, P = 0.002), and prior lower respiratory tract infection (OR: 1.82; 95%CI: 1.20-2.76, P = 0.005). The median time to recurrence was 100 days (interquartile range: 43-125), varying across clinical and environmental subgroups.

Children with certain demographic and clinical features have higher recurrent wheezing risk after ALRTI, highlighting the need for closer monitoring and early preventive care.