YOUNG adults who experienced bronchiolitis in infancy may face irreversible airway obstruction, according to new research linking early-life respiratory illness with long-term lung impairment. The study followed children hospitalized for bronchiolitis under six months of age and found that their lung function remained compromised nearly two decades later, even after bronchodilator treatment and adjustment for asthma and smoke exposure.
Researchers conducted a prospective follow-up of 166 full-term infants hospitalized for bronchiolitis, assessing lung function via spirometry at a mean age of 18.3 years. Of the original cohort, 72 former bronchiolitis patients and 28 controls underwent testing. Key spirometry parameters included FEV₁, FVC, and the FEV₁/FVC ratio, evaluated before and after bronchodilation.
Baseline FEV₁/FVC z-scores were significantly lower among bronchiolitis cases than controls (−0.90 vs 0.10, p = 0.001), and the difference persisted after bronchodilation (−0.54 vs −0.05, p = 0.028). Bronchiolitis-exposed individuals also had a significantly greater FEV₁ response to bronchodilation (6.3% vs 2.3%, p = 0.001), indicating increased airway reactivity. Importantly, these differences remained significant even after excluding participants with current asthma and adjusting for household smoke exposure.
The findings underscore bronchiolitis in early infancy as an independent risk factor for developing fixed obstructive lung patterns in young adulthood. While asthma and environmental exposures like tobacco smoke are known contributors to airway disease, this study suggests that bronchiolitis itself may cause persistent structural or functional changes in the lungs that do not fully respond to bronchodilators.
Given the lasting implications for pulmonary health, clinicians may consider bronchiolitis history in respiratory evaluations of adolescents and young adults, even in the absence of ongoing asthma symptoms.
Reference:
Saarikallio S et al. Bronchiolitis in Early Infancy Is Associated With Irreversible Airway Obstruction in Young Adulthood. Pediatr Pulmonol. 2025. doi:10.1002/ppul.71139 [Online ahead of print]
