PT  - JOURNAL ARTICLE
AU  - Evelien R. van Meel
AU  - Sara M. Mensink-Bout
AU  - Herman T. den Dekker
AU  - Tarunveer S. Ahluwalia
AU  - Isabella Annesi-Maesano
AU  - Syed Hasan Arshad
AU  - Nour Baïz
AU  - Henrique Barros
AU  - Andrea von Berg
AU  - Hans Bisgaard
AU  - Klaus Bønnelykke
AU  - Christian J. Carlsson
AU  - Maribel Casas
AU  - Leda Chatzi
AU  - Cecile Chevrier
AU  - Geertje Dalmeijer
AU  - Carol Dezateux
AU  - Karel Duchen
AU  - Merete Eggesbø
AU  - Cornelis van der Ent
AU  - Maria Fantini
AU  - Claudia Flexeder
AU  - Urs Frey
AU  - Fransesco Forastiere
AU  - Ulrike Gehring
AU  - Davide Gori
AU  - Raquel Granell
AU  - Lucy J. Griffiths
AU  - Hazel Inskip
AU  - Joanna Jerzynska
AU  - Anne M. Karvonen
AU  - Thomas Keil
AU  - Cecily Kelleher
AU  - Manolis Kogevinas
AU  - Gudrun Koppen
AU  - Claudia E. Kuehni
AU  - Nathalie Lambrechts
AU  - Susanne Lau
AU  - Irina Lehmann
AU  - Johnny Ludvigsson
AU  - Maria Christine Magnus
AU  - Erik Mélen
AU  - John Mehegan
AU  - Monique Mommers
AU  - Anne-Marie Nybo Andersen
AU  - Wenche Nystad
AU  - Eva S.L. Pedersen
AU  - Juha Pekkanen
AU  - Ville Peltola
AU  - Katharine C. Pike
AU  - Angela Pinot de Moira
AU  - Costanza Pizzi
AU  - Kinga Polanska
AU  - Maja Popovic
AU  - Daniela Porta
AU  - Graham Roberts
AU  - Ana Cristina Santos
AU  - Erica S. Schultz
AU  - Marie Standl
AU  - Jordi Sunyer
AU  - Carel Thijs
AU  - Laura Toivonen
AU  - Eleonora Uphoff
AU  - Jakob Usemann
AU  - Marina Vafeidi
AU  - John Wright
AU  - Johan C. de Jongste
AU  - Vincent W. V. Jaddoe
AU  - Liesbeth Duijts
TI  - Early-life respiratory tract infections and the risk of school-age lower lung function and asthma: a meta-analysis of 150 000 European children
AID  - 10.1183/13993003.02395-2021
DP  - 2022 Jan 01
TA  - European Respiratory Journal
PG  - 2102395
4099  - http://erj.ersjournals.com/content/early/2022/03/17/13993003.02395-2021.short
4100  - http://erj.ersjournals.com/content/early/2022/03/17/13993003.02395-2021.full
AB  - Background Early-life respiratory tract infections might affect chronic obstructive respiratory diseases, but conclusive studies from general populations are lacking.Objective To examine if children with early-life respiratory tract infections had increased risks of lower lung function and asthma at school-age.Methods We used individual-participant data of 150 090 children primarily from the EU Child Cohort Network to examine the associations of upper and lower respiratory tract infections from age 6 months to 5 years with forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC, forced expiratory flow at 75% of FVC (FEF75), and asthma at a median age of 7 (range 4 to 15) years.Results Children with early-life lower, not upper, respiratory tract infections had a lower school-age FEV1, FEV1/FVC and FEF75 (Z-score (95% CI): ranging from −0.09 (−0.14, −0.04) to −0.30 (−0.36, −0.24)). Children with early-life lower respiratory tract infections had a higher increased risk of school-age asthma than those with upper respiratory tract infections (OR (95%CI): ranging from 2.10 (1.98, 2.22) to 6.30 (5.64, 7.04)), and from 1.25 (1.18, 1.32) to 1.55 (1.47, 1.65)), respectively). Adjustment for preceding respiratory tract infections slightly decreased the strength of the effects. Observed associations were similar for those with and without early-life wheezing as proxy for early-life asthma.Conclusion Our findings suggest that early-life respiratory tract infections affect development of chronic obstructive respiratory diseases in later life, with the strongest effects for lower upper respiratory tract infections.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. Ahluwalia received funding for the current manuscript from the Novo Nordisk Foundation grant NNF180C0052457.Annesi-Maesano is member of the ATS Environment Health Policy Committee, the ERS Ethics and Integrity Committee, and the French IRD Ethics Committee.Conflict of interest: Dr. Arshad received funding for the manuscript from Asthma UK (grant no 364) and National Institutes of Health USA (grant no R01 HL082925).Conflict of interest: Dr. Barros received funding for the current manuscript from the Lundbeck Foundation (grant no R16-A1694), the Ministry of Health (grant no 903516), Danish Council for Strategic Research (grant no 0603-00280B) and the Capital Region Research Foundation.Conflict of interest: Dr. Eggesbø received paid honorarium for making small video's relating to allergy and asthma, by the Norwegian LHL organization.Conflict of interest: Dr. Frey received funding for the manuscript from the Swiss National Science Foundation (grant nr 320030_204717/1), and is chair of the National Steering Board, Swiss Personalized Health Network SPHN).Conflict of interest: Dr. Inskip received funding for the manuscript from the UK Medical Research Council and the European Union, and was President for the Society for Social Medicine and Population Health.Conflict of interest: Dr. Jerzynska received funding for the current manuscript from the National Science Centre, Poland (DEC-2014/15/B/N27/00998).Conflict of interest: Dr. Karvonen received funding for the present manuscript from the Academy of Finland (grants 139021; 287675; 296814; 296817; 308254), the Juho Vainio Foundation, EVO/VTR funding, Pavivikki and Sakari Sohlberg Foundation, Farmers’ Social Insurance Institution (Mela), the Finnish Cultural Foundation, the Foundation for Pediatric Research and the European Union (QLK4-CT-2001-0250).Conflict of interest: Dr. Mommers received grants from the Research Council of Norway (262700) and European Research Council (947684).Conflict of interest: Dr. de Moira received a Lundbeck Foundation fellowship (R264-2017-3099).Conflict of interest: Dr. Peltola received funding for the present manuscript from the Academy of Finland and the Foundation for Pediatric Research Finland. Katy Pike received consulting fees from Novartis and Spiriva, payment or honoraria for lectures from Novartis and is participating on a Data Safety Monitoring Board or Advisory Board Adherium. Kinga Polanska received funding for the current manuscript from the National Science Centre, Poland (DEC-2014/15/B/N27/00998), grant PRNF-218-AI-1/07 from Norway through the Norwegian Financial Mechanisms within the Polish-Norwegian Research Fund, and the Ministry of Science and Higher Education, Poland (PBZ-MEiN-/8/2//2006).Conflict of interest: Dr. Roberts is president of the BSACI.Conflict of interest: Dr. Santos received funding for the current manuscript from FCT Investigators contracts (IF/01060/2015).Conflict of interest: Dr. Sunyer received a grant from the ERC (Prenatal exposure to urban AIR pollution and pre- and postNatal Brain development (AIR-NB, contract number 785994).Conflict of interest: Dr. Usemann received grants from the Palatin Foundation, University of Basel Switzerland, Swiss Cancer League and Swiss Lung Foundation, and payments or honoraria for lectures from Vertex and Zurich Lung Foundation.Conflict of interest: Dr. Jaddoe received a grant from the European Research Council (ERC-2014-CoG-648916).Conflict of interest: Dr. Duijts received funding from cofunded ERA-Net on Biomarkers for Nutrition and Health (ERA HDHL), Horizon 2020 (grant agreement no. 696295; 2017), ZonMW The Netherlands (no. 529051014; 2017), Science Foundation Ireland (no. SFI/16/ERA-HDHL/3360) and the European Union (ALPHABET project).Conflict of interest: Dr. Evelien R. van Meel, Sara M. Mensink-Bout, Herman T. den Dekker, Syed Hasan Arshad, Nour Baïz, Andrea von Berg, Hans Bisgaard, Klaus Bønnelykke, Christian J. Carlsson, Maribel Casas, Leda Chatzi, Cecile Chevrier, Geertje Dalmeijer, Carol Dezateux, Karel Duchen, Cornelis van der Ent, Maria Fantini, Claudia Flexeder, Fransesco Forastiere, Ulrike Gehring, Davide Gori, Raquel Granell, Lucy J. Griffiths, Thomas Keil, Cecily Kelleher, Manolis Kogevinas, Gudrun Koppen, Claudia E. Kuehni, Nathalie Lambrechts, Susanne Lau, Irina Lehmann, Johnny Ludvigsson, Maria Christine Magnus, Erik Mélen, John Mehegan,Anne-Marie Nybo Andersen, Wenche Nystad, Eva S.L. Pedersen, Juha Pekkanen, Katharine C. Pike, Costanza Pizzi, Kinga Polanska, Maja Popovic, Daniela Porta, Erica S. Schultz, Marie Standl, Carel Thijs, Laura Toivonen, Eleonora Uphoff, Marina Vafeidi, John Wright, Johan C. de Jongste have nothing to disclose.