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Influenza Other Respir Viruses . Lower cognitive scores among toddlers in birth cohorts with acute respiratory illnesses, fevers, and laboratory-con

tetano

Editor, Senior Moderator
Influenza Other Respir Viruses


. 2021 Sep 14.
doi: 10.1111/irv.12904. Online ahead of print.
Lower cognitive scores among toddlers in birth cohorts with acute respiratory illnesses, fevers, and laboratory-confirmed influenza


Eduardo Azziz-Baumgartner[SUP] 1 [/SUP], Rosalba Gonzalez[SUP] 2 [/SUP], William Davis[SUP] 1 [/SUP], Arlene Calvo[SUP] 2 3 [/SUP], Natalie Olson[SUP] 1 [/SUP], Lauren Grant[SUP] 1 [/SUP], Morgan Hess-Holtz[SUP] 3 [/SUP], Vic Veguilla[SUP] 1 [/SUP], Rafael Rauda[SUP] 4 [/SUP], Susan Cornelia Kaydos-Daniels[SUP] 1 [/SUP], Nestor Sosa[SUP] 2 [/SUP], Evelina I Aedo Ruíz[SUP] 5 [/SUP], Julio Armero Guardado[SUP] 4 [/SUP], Rachael Porter[SUP] 1 [/SUP], Danilo Franco[SUP] 2 [/SUP], Juan Miguel Pascale[SUP] 2 [/SUP], Georgina Peacock[SUP] 1 [/SUP]



Affiliations

Abstract

Background: We established cohorts to assess associations between viral influenza and cognitive development to inform the value proposition of vaccination.
Methods: From 2014 through 2017, we called women seeking care at four prenatal clinics in Panama and El Salvador to identify acute respiratory illnesses (ARIs). Within 2 weeks of childbirth, mothers were asked to enroll their neonates in the cognitive development study. Staff obtained nasopharyngeal swabs from children with febrile ARIs for real-time reverse transcription polymerase chain reaction (rtPCR) detection of viral RNA. Toddlers were administered Bayley developmental tests at ages 12 and 18-24 months. We used multilevel linear regression to explore associations between Bayley scores, ARIs, fever, and laboratory-confirmed influenza, controlling for maternal respiratory or Zika illnesses, infant influenza vaccination, birth during influenza epidemics, and the number of children in households.
Results: We enrolled 1567 neonates of which 68% (n = 1062) underwent developmental testing once and 40% (n = 623) twice. Children with previous ARIs scored an average of 3 points lower on their cognitive scores than children without ARIs (p = 0.001). Children with previous fevers scored an average of 2.1 points lower on their cognitive scores than afebrile children (p = 0.02). In the second year, children with previous laboratory-confirmed influenza scored 4 points lower on their cognitive scores than children without influenza (p = 0.04, after controlling for first Bayley cognitive scores).
Conclusions: ARIs and fever during infancy were associated with lower Bayley scores at 12 months, and laboratory-confirmed influenza was associated with lower cognitive scores at 24 months suggesting the potential value of vaccination to prevent non-respiratory complications of influenza.

Keywords: acute respiratory illness; cognitive development; febrile illness; influenza.
 
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