Factors Associated with Recurrent Respiratory Illness Following COVID-19 Hospitalization in Infants: A Case Control Study at Nong Bua Daeng Hospital
Keywords:
COVID-19, infant, recurrent respiratory tract diseases, long-covid symptoms, risk factorsAbstract
The COVID-19 pandemic has affected the risk of recurrent respiratory tract infections following infection in infants; however, studies in this area remain limited. This study aimed to identify factors associated with recurrent respiratory tract infections following COVID-19 infection in children under one year of age. A prospective cohort study was conducted among infants infected with COVID-19 who received inpatient treatment between October 2021 and September 2022 at Nong Bua Daeng Hospital, Chaiyaphum Province, with continuous follow-up for two years until September 2024. Cases were defined as infants with respiratory tract infections occurring three or more times within one year or pneumonia occurring two or more times within two years. Data analysis employed descriptive statistics, and multivariate risk factor analysis was performed using multiple logistic regression.
Results from a total of 96 patients revealed recurrent respiratory tract infections in 32 cases (33.3%). The case group exhibited more severe clinical manifestations than the control group, with significantly higher rates of cough (81.3% versus 59.4%, p = 0.027) and crying/irritability/fussiness (71.9% versus 43.8%, p = 0.008). The case group also had a higher proportion of cesarean delivery (34.4% versus 17.2%, p = 0.059) and elevated white blood cell counts (23.3% versus 7.8%, p = 0.049). Extended model analysis identified important risk factors including crying/irritability/fussiness (adjusted OR = 3.71; 95% CI: 1.30, 10.60), cesarean delivery (adjusted OR = 2.04; 95% CI: 0.68, 6.12), and elevated white blood cell count (adjusted OR = 3.83; 95% CI: 0.91, 16.10). The model demonstrated adequate accuracy and statistical fitness.
This study found that crying/irritability/fussiness was the most significant risk factor for recurrent respiratory tract infections in infants following COVID-19 infection, followed by history of cesarean delivery and elevated white blood cell count. These findings support the development of clinical symptom-based screening tools to identify at-risk groups and plan appropriate follow-up. Further long-term follow-up studies incorporating environmental factors are recommended.
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