Symptom Burden and Factors Associated with Acute Respiratory Infections in the First Two Years of Life-Results from the LoewenKIDS Cohort

Susan Langer, Johannes Horn, Cornelia Gottschick, Bianca Klee, Oliver Purschke, Mahrrouz Caputo, Evelyn Dorendorf, Kristin Maria Meyer-Schlinkmann, Heike Raupach-Rosin, André Karch, Nicole Rübsamen, Mustafa Aydogdu, Matthias Buhles, Frank Dressler, Wolfgang Eberl, Franz Edler von Koch, Torsten Frambach, Heiko Franz, Florian Guthmann, Carlos A Guzman, Roland Haase, Gesine Hansen, Valerie Heselich, Johannes Hübner, Hans Georg Koch, Carsten Oberhoff, Peggy Riese, Ralf Schild, Sven Seeger, Michael Tchirikov, Stephanie Trittel, Constantin von Kaisenberg, Rafael Mikolajczyk, Susan Langer, Johannes Horn, Cornelia Gottschick, Bianca Klee, Oliver Purschke, Mahrrouz Caputo, Evelyn Dorendorf, Kristin Maria Meyer-Schlinkmann, Heike Raupach-Rosin, André Karch, Nicole Rübsamen, Mustafa Aydogdu, Matthias Buhles, Frank Dressler, Wolfgang Eberl, Franz Edler von Koch, Torsten Frambach, Heiko Franz, Florian Guthmann, Carlos A Guzman, Roland Haase, Gesine Hansen, Valerie Heselich, Johannes Hübner, Hans Georg Koch, Carsten Oberhoff, Peggy Riese, Ralf Schild, Sven Seeger, Michael Tchirikov, Stephanie Trittel, Constantin von Kaisenberg, Rafael Mikolajczyk

Abstract

Acute respiratory infections (ARIs) are the most common childhood illnesses worldwide whereby the reported frequency varies widely, often depending on type of assessment. Symptom diaries are a powerful tool to counteract possible under-reporting, particularly of milder infections, and thus offer the possibility to assess the full burden of ARIs. The following analyses are based on symptom diaries from participants of the German birth cohort study LoewenKIDS. Primary analyses included frequencies of ARIs and specific symptoms. Factors, which might be associated with an increased number of ARIs, were identified using the Poisson regression. A subsample of two hundred eighty-eight participants were included. On average, 13.7 ARIs (SD: 5.2 median: 14.0 IQR: 10-17) were reported in the first two years of life with an average duration of 11 days per episode (SD: 5.8, median: 9.7, IQR: 7-14). The median age for the first ARI episode was 91 days (IQR: 57-128, mean: 107, SD: 84.5). Childcare attendance and having siblings were associated with an increased frequency of ARIs, while exclusive breastfeeding for the first three months was associated with less ARIs, compared to exclusive breastfeeding for a longer period. This study provides detailed insight into the symptom burden of ARIs in German infants.

Keywords: LoewenKIDS; birth cohort; children; infectious diseases; longitudinal observation; newborn; respiratory infection; symptom burden; symptom diary.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(A) Histogram of all days with symptoms within the first two years of life. (B) Cumulative distribution of days with symptoms within the first two years of life. (C) Cumulative distribution of days with specific symptoms in the first two years of life. (D) Cumulative distribution of days with any symptoms in the first two years of life in six months age strata.
Figure 2
Figure 2
(A) ARI episodes of all children in the first two years of life. (B) Cumulative distribution of ARI episodes. (C) Proportion of children with ARIs in the first two years of life per day (in days after birth). (D) Proportion of children with ARIs by month (season).

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