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Respiratory morbidity before and during the COVID-19 pandemic from birth to 18 months in a Swedish birth cohort - 23/01/25

Doi : 10.1016/j.jaci.2024.12.1080 
Fanny Kelderer, MD a, , Gabriel Granåsen, PhD b, Sophia Holmlund, RNM, PhD c, d, e, Sven Arne Silfverdal, MD, PhD a, Hilde Bamberg, MSc a, Monique Mommers, PhD f, John Penders, PhD g, Magnus Domellöf, MD, PhD a, Ingrid Mogren, MD, PhD d, Christina E. West, MD, PhD a
a Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden 
b Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden 
c Department of Nursing, Umeå University, Umeå, Sweden 
d Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden 
e Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Australia 
f Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands 
g Department of Medical Microbiology, Infectious Diseases and Infection Prevention, NUTRIM Institute of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands 

Corresponding author: Fanny Kelderer, MD, Department of Clinical Sciences, Pediatrics, Umeå University SE-901 85 Umeå, Sweden.Department of Clinical SciencesPediatricsUmeå UniversityUmeåSE-901 85Sweden

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Graphical abstract




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Abstract

Background

Respiratory infections in early life are an identified risk factor for asthma. We hypothesized that infection-prevention measures during the coronavirus disease 2019 (COVID-19) pandemic influenced the risk of respiratory morbidity and aeroallergen sensitization in early childhood.

Objective

We compared respiratory morbidity and aeroallergen sensitization in children born before and during the pandemic.

Methods

We compared a COVID-19 category (exposed children; n = 1661) to a pre–COVID-19 category (nonexposed children; n = 1676) by using data from the prospective population-based NorthPop Birth Cohort study in Sweden. Data on respiratory morbidity and concomitant medication were retrieved from national registers. Prospectively collected data on respiratory morbidity using web-based questionnaires at 9 and 18 months of age were applied. At age 18 months, serum IgE levels to aeroallergens were determined (n = 1702).

Results

The risk of developing any respiratory tract infection (adjusted odds ratio [aOR] = 0.33 [95% CI, 0.26-0.42]), bronchitis (aOR = 0.50 [95% CI, 0.27-0.95]) and croup (aOR = 0.59 [95% CI, 0.37-0.94]) were decreased in the COVID-19 category. The risk of wheeze in the first 9 months was lower in the COVID-19 category (aOR = 0.70 [95% CI, 0.55-0.89]). There were also fewer prescriptions of antibiotics in the COVID-19 category. The prevalence of aeroallergen sensitization was similar between categories.

Conclusion

Children born during the COVID-19 pandemic demonstrated significantly decreased risks of respiratory infections and prescribed antibiotics until 18 months of age compared to children born before the COVID-19 pandemic. Whether this will affect the risk of developing asthma in childhood is being followed.

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Key words : Asthma, birth cohort, COVID-19, epidemiology, hygiene, infancy, NorthPop, respiratory infections, sensitization, wheeze

Abbreviations used : aOR, COVID-19, IPW, IRR, NPR, OR, SARS-CoV-2, SD, SPDR, URI


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© 2024  The Authors. Publicado por Elsevier Masson SAS. Todos los derechos reservados.
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