ArticleThe Lancet regional health. Europe2026
Infant respiratory syncytial virus and childhood asthma: a nationwide registry-based, sibling-controlled, and genome-wide association study.
Article in The Lancet regional health. Europe, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Early-life respiratory syncytial virus (RSV) infection is associated with childhood recurrent wheeze or asthma (RW/A), but causality and shared genetic liability remain unclear. Methods: We combined Finnish nationwide registries and Nordic genetic cohorts. First, in 965,312 Finnish children born between 1998 and 2014, we defined severe RSV as RSV hospitalisation before age 1 year, and recurrent wheezing or asthma (RW/A) as inhaled medication reimbursement between ages 1 and 7 years, and compared medication and eosinophil trajectories by RSV history. Second, we assessed familial confounding in 527,776 full siblings and 15,667 RW/A-discordant pairs. Third, we performed a genome-wide association study (GWAS) of RSV susceptibility with meta-analysis across six Nordic cohorts (3107 cases, 92,091 controls) and two-sample Mendelian randomisation (MR) using 155 asthma-associated variants. Findings: RSV-associated RW/A showed higher inhaled medication use at ages 1-2 years but lower use after age 5, and lower mean blood eosinophils (0.341 vs. 0.398 × 10 Interpretation: The RSV-asthma association is unlikely to be explained by shared genetic or environmental factors, and RSV-associated RW/A shows a distinct trajectory. These findings help prioritise long-term outcomes for RSV prevention trials and monitoring. Funding: Päivikki and Sakari Sohlberg Foundation, Foundation for Pediatric Research, Sigrid Jusélius Foundation, Orion Research Foundation, the Research Council of Norway.
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