Asthma Risk Is Linked to Age at First Respiratory Syncytial Virus Infection

Children who develop respiratory syncytial virus (RSV) infection at age 6 months or older have a 2- to 7-fold greater rate of subsequent hospitalization for asthma compared with children who develop RSV infection when they are younger than 6 months, according to a new study.

To evaluate the association between the age at first severe RSV infection and subsequent asthma, the researchers studied data on 18,042 individuals who were born in New South Wales, Australia, from 2001 through 2010 and who had been hospitalized at least once for RSV infection within the first 2 years of life.

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The researchers grouped the children into 4 subsets: those who were hospitalized for RSV at younger than 3 months of age, those who were hospitalized for RSV between 3 and 6 months of age, those who were hospitalized for RSV between 6 and 12 months of age, and those who were hospitalized for RSV at 12 to 24 months of age.

Within each of these 4 groups, the researchers calculated the incidence rates and rate ratios of the first asthma-associated hospitalization after 2 years of age.

The incidence of asthma-associated hospitalization per 1000 child-years was 0.5 among children hospitalized for RSV at younger than 3 months of age, 0.9 among children hospitalized for RSV between 3 and 6 months of age, 2.0 among children hospitalized for RSV between 6 and 12 months of age, and 1.7 among children hospitalized for RSV at 12 to 24 months of age.

The children who had been hospitalized for RSV at age 6 months or younger had a rate ratio of hospitalization for asthma that was 2- to 7-fold greater than their counterparts who had been hospitalized for RSV at age 0 to 6 months.

“Although the burden of RSV disease is highest in children aged [younger than] 6 months, the burden of subsequent asthma is higher in children who develop RSV disease at ages 6 months [or older],” the researchers concluded. “The development of asthma following early RSV infection is likely due to short-term and long-term alterations in the airway physiology and in the airway immune response.”

—Colleen Murphy

Reference:

Homaira N, Briggs N, Oei J-L, et al. Association of age at first severe respiratory syncytial virus disease with subsequent risk of severe asthma: a population-based cohort study. J Infect Dis. 2019;220(4):550-556. doi:10.1093/infdis/jiy671.