Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
J Infect Dis. 2022 Jan 5;225(1):42-49. doi: 10.1093/infdis/jiab313.
Whether acute respiratory illnesses (ARIs), often associated with virus detection, are associated with lower risk for subsequent ARI remains unclear. We assessed the association between symptomatic ARI and subsequent ARI in young children.
In a prospective cohort of Peruvian children <3 years, we examined the impact of index ARI on subsequent ARI risk. Index ARI were matched with ≤3 asymptomatic observations and followed over 28 days. We compared risk of subsequent ARI between groups using conditional logistic regression adjusting for several covariates, accounting for repeat observations from individual children.
Among 983 index ARI, 339 (34%) had an ARI event during follow-up, compared with 876/2826 (31%) matched asymptomatic observations. We found no significant association of index ARI and subsequent ARI risk during follow-up overall (adjusted odds ratio [aOR], 1.10; 95% confidence interval [CI], .98-1.23) or when limited to index ARI with respiratory viruses detected (aOR, 1.03; 95% CI, .86-1.24). Similarly, when the outcome was limited to ARI in which viruses were detected, no significant association was seen (aOR, 1.05; 95% CI, .87-1.27).
ARIs were not associated with short-term protection against subsequent ARI in these children. Additional longitudinal studies are needed to understand drivers of recurrent ARI in young children.
急性呼吸道疾病（ARI）常与病毒检测相关，但其是否与随后发生的 ARI 风险降低相关尚不清楚。我们评估了有症状的 ARI 与幼儿随后发生 ARI 的关系。
在一项秘鲁幼儿（<3 岁）的前瞻性队列研究中，我们研究了指数 ARI 对随后发生 ARI 风险的影响。指数 ARI 与 ≤3 次无症状观察结果相匹配，并随访 28 天。我们使用条件逻辑回归比较了两组之间随后发生 ARI 的风险，该回归调整了几个协变量，考虑了个体儿童的重复观察结果。
在 983 次指数 ARI 中，有 339 次（34%）在随访期间发生了 ARI 事件，而在 2826 次匹配的无症状观察中，有 876 次（31%）发生了 ARI 事件。我们没有发现指数 ARI 与整个随访期间随后发生 ARI 风险之间存在显著关联（调整后的比值比[aOR]，1.10；95%置信区间[CI]，.98-1.23），也没有发现当仅限于检测到呼吸道病毒的指数 ARI 时存在显著关联（aOR，1.03；95% CI，.86-1.24）。同样，当结局仅限于检测到病毒的 ARI 时，也没有发现显著关联（aOR，1.05；95% CI，.87-1.27）。
在这些儿童中，ARI 与随后发生 ARI 的短期保护无关。需要进一步的纵向研究来了解幼儿反复发生 ARI 的驱动因素。
