Childhood pneumonia associated with higher risk of death from respiratory infection in adulthood

According to a study published in the journal The Lancet, respiratory infections contracted in early childhood are associated with an increased risk of death from respiratory disease between the ages of 26 and 73.
The study suggests that although the overall number of premature deaths from respiratory disease was small, people who had a lower respiratory tract infection (LRTI) such as bronchitis or pneumonia were 93 percent more likely to die prematurely at age two. from respiratory disease in adulthood, regardless of socioeconomic background or smoking status.
Chronic respiratory diseases are a major public health problem, with an estimated 3.9 million deaths in 2017, accounting for 7 percent of all deaths worldwide, the researchers said.
Chronic obstructive pulmonary disease (COPD) caused most of these deaths, they said. Infant LRTIs have been shown to be associated with the development of adult lung dysfunction, asthma and COPD, but it was previously unclear whether there was an association with premature death in adulthood.
The latest research is the first lifetime study on the topic and provides the best evidence yet to suggest that early respiratory health affects mortality later in life.
“Current prevention measures for adult respiratory disease mainly focus on adult lifestyle risk factors such as smoking, association of one in five adult respiratory deaths with common infections many decades earlier in childhood shows the need to target risk well before adulthood ” said James Allinson of Imperial College London, UK and lead author of the study.
The study used data from a UK-wide cohort (The National Survey of Health and Development) that recruited individuals at birth in 1946 and tracked health and death records up to 2019. Of the 3,589 study participants, 25 percent had an LRTI before the age of two. By the end of 2019, 19 percent of participants had died before age 73.
Of these 674 premature deaths in adults, 8 percent of participants died of respiratory disease, mostly COPD. Analysis adjusted for childhood socioeconomic background and smoking suggests that children who had an LRTI by age two were 93 percent more likely to die prematurely in adulthood from respiratory disease than children who did not have an LRTI by age two.
That equates to 2.1 percent of premature adult death from respiratory disease among those who had an LRTI in early childhood, compared with 1.1 percent among those who did not report an LRTI before age two, the researchers said.
A lower respiratory tract infection before the age of two was only associated with an increased risk of early death from respiratory disease, not other diseases such as heart disease or cancer, they said.
“The results of our study suggest that efforts to reduce childhood respiratory infections could have an impact on addressing premature mortality from respiratory disease later in life. We hope this study will help guide the strategies of international health organizations to tackle this problem,” said Professor Rebecca Hardy from Loughborough University and University College London, UK.
The authors acknowledge some limitations of the study. Although socio-economic background and smoking were adjusted for in the analysis, there may have been other factors that were not reported, such as parental smoking and prematurity. During this lifetime study, societal changes may also have led to changes in the lung function of subsequent cohorts, altering the results. The study was unable to investigate which bacteria or viruses caused LRTI in the children.
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