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Long-term prospective study in children after respiratory syncytial virus infection
Insights
Respiratory syncytial virus (RSV) hospitalization in infancy can lead to long-term lung function issues. Parental smoking is linked to RSV illness, and lung abnormalities persist for years, regardless of atopy development.
Area of Science:
- Pediatrics
- Pulmonology
- Infectious Diseases
Background:
- Infants hospitalized with respiratory syncytial virus (RSV) lower respiratory tract illness may face long-term health consequences.
- Parental smoking is a significant risk factor for RSV-related hospitalizations.
Purpose of the Study:
- To prospectively evaluate the long-term pulmonary function in children hospitalized with RSV during infancy.
- To identify risk factors and associated conditions in children following severe RSV infections.
Main Methods:
- Prospective evaluation of 29 children hospitalized with RSV during infancy over 8 years.
- Assessment of atopy (serum IgE, radioallergosorbent testing), recurrent lower respiratory tract disease, and pulmonary function (ear oximetry, spirometry).
Main Results:
- Parental smoking history was significantly associated with RSV hospital admission.
- Only 10% of children developed atopy; 21% experienced recurrent lower respiratory tract disease.
- 55% had low oxyhemoglobin levels initially, with 21% persistently low by year 8.
- Spirometry indicated peripheral airway obstruction in affected children.
Conclusions:
- RSV lower respiratory tract infections are associated with chronic pulmonary function abnormalities detected up to 8 years post-illness.
- These long-term lung function deficits are not exclusive to children who develop atopy.
- Early life RSV infection poses a risk for persistent respiratory issues throughout childhood.
Abstract:
We have prospectively evaluated for the past 8 years 29 children who were hospitalized during infancy with acute lower respiratory tract illness caused by respiratory syncytial virus (RSV). No differences in the prevalence of a family history of atopy or breast-feeding in these infants compared with controls were noted. However, a history of parental smoking was significantly associated with hospital admission for RSV lower respiratory tract disease. Evidence of atopy, as defined by serum IgE levels and radioallergosorbent testing, have developed in only three (10%) of 29 children. Six children (21%) continue to have recurrent lower respiratory tract disease. Fifty-five percent of these children had abnormally low oxyhemoglobin levels (SaO2) measured by ear oximetry for the first 3 to 4 years after the acute illness. Twenty-one percent have persistently low SaO2 levels during the eighth year of follow-up. Spirometric values indicate evidence of peripheral airway obstruction. These studies suggest that an association between RSV lower respiratory tract infections and chronic abnormalities of pulmonary function may be detected sequentially through the first 8 years of life. These abnormalities are not limited to those children developing an atopic state during that same time period.