Effect of pneumonia in childhood on adult lung function

Chronic obstructive pulmonary disease is a major health burden. Evidence th at childhood lower respiratory tract infection (LRTI) is associated with re duced adult lung function and thereby with chronic obstructive pulmonary di sease comes from 3 sources. First, studies of children hospitalized with sp ecific LRTIs, for example, as a result of respiratory syncytial virus, show reduced lung function 7 to 10 years later, but many have diagnostic and re ferral biases. Second, population studies show that adults reporting childh ood LRTI have reduced lung function, but retrospective ascertainment of LRT I is unreliable. Finally, in the largest study of adults with independent a scertainment of childhood LRTI, those with pneumonia before age 7 years had a 6% to 7% lower unadjusted mean forced expiratory volume in 1 second and forced vital capacity The deficits in adjusted lung function persisted afte r albuterol was administered and were neither due to wheezing illness nor d iminished after results were controlled for confounders. Loss of lung funct ion was no gr eater in those with pneumonia at age <2 years than in those w ith pneumonia at age 2 to 7 years. This and similar studies strongly suppor t an association between childhood pneumonia and a reduction in adult lung volume, whereas follow-up studies of children with specific LRTIs show an o bstructive defect. Ongoing studies that have ascertained premorbid lung fun ction should help determine whether pneumonia causes this deficit or is com moner in those with poorer premorbid lung function.