RSV infection during infancy tied to onset of asthma in childhood: Lancet

There is well-established data on the association between Early-life severe respiratory syncytial virus (RSV) infection and the onset of childhood wheezing illnesses. However, the role of RSV infection during infancy and childhood asthma onset needs more data and further clarification.

Considering this background, researchers assessed the association between RSV infection in infancy and childhood asthma.

Know about INSPIRE study:

• It is a large birth cohort of healthy infants with non-low birthweight born at term.
• Infants were recruited from 11 paediatric practices in USA.
• Combining passive and active surveillance with viral identification through molecular and serological techniques ascertained RSV infection status (no infection vs infection) in the first year of life.
• Children were followed up to check asthma in those who completed a 5-year follow-up.

The study’s findings could be summarised as follows:

• One thousand nine hundred forty-six children were enrolled.
• 1741 constituting 89%, had available data to assess status of RSV infection in the first year of life.
• Nine hundred ninety-four children had RSV infection during infancy, constituting 54%.
• There was a low proportion of children with 5-year current asthma in those without RSV infection during infancy (91/587) than those with RSV infection during infancy (139/670).
• The risk of 5-year current asthma was lower by 26 % when uninfected with RSV during infancy compared to those infected with RSV during infancy, having adjusted RR 0·74.
• Avoiding RSV infection during infancy could prevent nearly 15 % of asthma cases.

Interpreting further, they said the risk of developing childhood asthma was lower in children born at term and uninfected with RSV in the first year of life.

Based on the findings of our study, we found an age-dependent association between RSV infection during infancy and childhood asthma.

Further investigations are warranted.

US National Institutes of Health funded the study, as acknowledged.

Further reading:

Respiratory syncytial virus infection during infancy and asthma during childhood in the USA (INSPIRE): a population-based, prospective birth cohort study. Christian Rosas-Salazar, MD.April 19, 2023DOI:https://doi.org/10.1016/S0140-6736(23)00811-5