Infectious diseases

Childhood pneumonia and pleurisy lead to smaller lungs: Tasmanian study


Episodes of childhood pneumonia or pleurisy by age seven are associated with modestly smaller lung volumes in middle age, according to new research.

The research, from the Tasmanian Longitudinal Health Study cohort, involved comprehensive measures of lung function in participants at age seven and again at ages 45 and 53.

The study found that in 14.2% of children, parents reported their child had experienced a doctor-diagnosed pneumonia or pleurisy. This was associated with mildly obstructive pre-bronchodilator spirometry at age seven.

Childhood pneumonia/pleurisy was also associated with 3.02-fold increase in spirometric restriction at ages 45 and 53 compared to participants with no history of childhood pneumonia.

Total lung capacity (TLC) and functional residual capacity (FRC) were reduced across increasing childhood pneumonia/pleurisy categories from never (0 episodes) to ever (1-2 episodes) and recurrent (>2 episodes).

The impact was greater in never smokers compared to ever-smokers.

Childhood pneumonia/pleurisy was also associated with increases in carbon monoxide transfer coefficient (Kco) (ie, TLco per unit of accessible alveolar volume) at ages 45 and 53 years.

Lead author Dr Jennifer Perret, from the School of Population and Global Health at the University of Melbourne, told the limbic that while the reduction in total lung capacity in middle-age was only modest, it might be clinically important for people who otherwise have low lung function and other respiratory risk factors.

“While not a sufficient cause of restrictive lung disease by itself, it can contribute to, or can be a component of a lung disease that features reduced lung function. While we have not directly shown this using our data, poorer lung growth during childhood and adolescence is now regarded to contribute to a lung function trajectory that predisposes to COPD in later life.”

“While potentially reducing lung volumes further, we did not find any evidence for co-existent lung tissue damage in mid-adult life, which is typically present in fibrotic lung diseases.”

The study noted limitations of the study included possible confounders such as incomplete data on participants’ birthweights and lung function prior to the episodes of childhood pneumonia.

“Birth weight is an important predictor of adult lung function and it is a limitation that was not adjusted for. But similar results were seen for another similar cohort that addressed the same research question for a single time-point in middle-age that did adjust for birth weight,” Dr Perret said.

“Also, the lack of spirometric restriction and presence of airflow obstruction in children with asthma provides evidence for a temporal relationship between having pneumonia/pleurisy in childhood and ‘smaller lungs’ in adult life.”

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