Lower respiratory tract infection in early childhood linked with higher risk of dying from respiratory disease as an adult, study finds

By Janelle Chavez, CNN

Adults who had a lower respiratory tract infection such as bronchitis or pneumonia before the age of 2 may be at higher risk of dying prematurely from respiratory disease, according to a new study. Experts say the decades-long research may not directly apply to today’s kids but shows how health effects can linger over a lifetime.

The study, published Tuesday in The Lancet, followed 3,589 people across England and Wales who were born in 1946 and looked at health and death records up to 2019.

The researchers found that people who had a lower respiratory tract infection during early childhood were 93% more likely to die by age 73 compared with those who didn’t have a lower respiratory tract infection during early childhood.

Just over 2% of the participants who had had an infection at a young age died prematurely, compared with 1.1% of those without infections. The association was independent of socioeconomic factors and smoking status.

Even if things are different for today’s children, the research offers a note of caution for older people and shows how we can carry health effects over our entire lives.

“Our kids get vaccinated for pneumococcal pneumonia. They get vaccinated for pertussis,” said Dr. Christian Sandrock, a physician in pulmonology at the University of California Davis Medical Center who was not involved in the study. “So I don’t think this study translates into what happens for kids nowadays, but I think it really relays the importance of childhood lower respiratory tract infections, including in older adults that we manage now.”

Early childhood is a critical period of lung development, and experts say that lower respiratory tract infections in those years can cause damage and scarring that increases the risk of airway disease.

“Any sort of insult that happens during that period of lung growth could diminish your lung capacity. And so you start adulthood, basically, without a full tank of gas from a lung perspective,” said Dr. Andrea Jonas, a physician in pulmonology and critical care medicine at Stanford University who was not involved with the research.

In the study, adult deaths from respiratory disease increased with more frequent early childhood lower respiratory tract infection, infections requiring hospitalization or infection before 1 year of age.

The researchers also reported that early childhood lower respiratory infections accounted for 1 in 5 premature adult deaths from respiratory disease, which they say challenges the assumption that life-limiting diseases such as COPD result only from choices made as adults.

“Current preventative measures for adult respiratory disease mainly focus on adult lifestyle risk factors such as smoking. Linking one in five of adult respiratory deaths to common infections many decades earlier in childhood shows the need to target risk well before adulthood,” Dr. James Allinson, lead author of the study and a respiratory consultant at Royal Brompton Hospital, said in a statement. “To prevent the perpetuation of existing adult health inequalities, we need to optimize childhood health.”

Sandrock says that although children today may not carry the same risk reported in the decades-long study, those who develop a lower respiratory tract infection before the age of 2 should get the appropriate vaccines to decrease the risk of future infections.

Pulmonary function tests and scans like X-rays or CT scans can show signs of damage or scarring from lower respiratory tract infections. Jonas says that people who have this damage and scarring should avoid nicotine products to preserve lung function.

“You start out with less than a full tank of gas, and then you’re using up your lung capacity that much faster if you add smoking to the equation,” she said.

Experts recommend that older adults who had lung infections at young ages should maintain lung health with regular exercise and lung cleansing techniques.

“They are not the same as someone without an infection in their childhood,” Sandrock said. “You want to be able to have them in a better place so they can handle the bumps that come down the road and not end up dying of a respiratory infection.”

Experts hope the new research emphasizes the importance of preventing and promptly treating respiratory infections.

“Lung health is something that has really come to the forefront,” Jonas said, and the study “really highlights the importance of healthy lungs to lead to a long, healthy life.”

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