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Understanding recurrent wheezing: A parent's guide
Thamonpan Kiatvitchukul1, Pandaree Dokkham1, Kornthip Jeephet2
1Department of Pediatrics, Naresuan University, Phitsanulok 65000, Thailand.
Insights
Recurrent wheezing after acute lower respiratory tract infection (ALRTI) is common in young children. Key risk factors include age, prematurity, allergies, urban living, eosinophilia, and prior infections, necessitating closer monitoring.
Area of Science:
- Pediatric Respiratory Medicine
- Epidemiology
- Clinical Research
Background:
- Recurrent wheezing post-acute lower respiratory tract infection (ALRTI) is a frequent pediatric issue.
- It may signal developing chronic respiratory conditions in early childhood.
- Identifying risk factors is crucial for timely intervention and prevention strategies.
Purpose of the Study:
- To determine risk factors associated with recurrent wheezing episodes in children following ALRTI.
- To investigate the temporal patterns of wheezing recurrence after ALRTI.
Main Methods:
- A retrospective cohort study involved pediatric patients (≤5 years) hospitalized with ALRTI and wheezing.
- Data were collected from July 2020 to June 2023 and analyzed over a 12-month follow-up period.
- Multivariable logistic regression and survival analyses (Kaplan-Meier, log-rank tests) were employed to identify risk factors and compare outcomes.
Main Results:
- Significant risk factors for recurrent wheezing included: age 12-24 months (OR 2.38), prematurity (OR 1.66), allergic rhinitis (OR 1.50), urban residency (OR 1.68), eosinophilia (OR 3.29), and prior ALRTI (OR 1.82).
- The median time to recurrence was 100 days, with variations observed across subgroups.
- Statistical significance was confirmed for all identified predictors (P < 0.05).
Conclusions:
- Specific demographic and clinical characteristics increase the risk of recurrent wheezing after ALRTI in children.
- These findings underscore the importance of vigilant monitoring and proactive preventive care for at-risk pediatric populations.
- Early identification of these risk factors can guide targeted management strategies.
Background:
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.
Aim:
To investigate the risk factors and timing of recurrent wheezing episodes following ALRTI in children.
Methods:
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.
Results:
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.
Conclusion:
Children with certain demographic and clinical features have higher recurrent wheezing risk after ALRTI, highlighting the need for closer monitoring and early preventive care.
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