Kiatvitchukul T, Dokkham P, Jeephet K, Srisingh K. Understanding recurrent wheezing: A parent’s guide. World J Clin Pediatr 2026; 15(1): 113430 [DOI: 10.5409/wjcp.v15.i1.113430]
Corresponding Author of This Article
Klaita Srisingh, Associate Professor, Department of Pediatrics, Naresuan University, 99 Moo 9, Phitsanulok-Nakhonsawan Road, Thapho Subdistrict, Phitsanulok 65000, Thailand. klaitas@nu.ac.th
Research Domain of This Article
Pediatrics
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Thamonpan Kiatvitchukul, Pandaree Dokkham, Klaita Srisingh, Department of Pediatrics, Naresuan University, Phitsanulok 65000, Thailand
Kornthip Jeephet, Statistics Technical Officer, Research Center of the Faculty of Medicine, Naresuan University, Phitsanulok 65000, Thailand
Author contributions: Srisingh K and Kiatvitchukul T designed the study; Kiatvitchukul T and Srisingh K were responsible for developing the methodology; Dokkham P, Jeephet K and Srisingh K participated in the formal analysis and investigation; Kiatvitchukul T and Srisingh K wrote the original draft; Srisingh K had full access to all study data and was responsible for the integrity of the data and the accuracy of the analysis; Srisingh K also confirmed that all authors met authorship criteria and was responsible for submitting the manuscript; and all authors have read and approve the final manuscript.
Institutional review board statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. The study was conducted in accordance with the Declaration of Helsinki and its subsequent amendments. The study was approved by the Naresuan University Institutional Review Board (COA No. 172/2025, IRB No. P3-0055/2568).
Informed consent statement: Since this research was retrospective in nature, individual informed consent was not required. However, in cases where clinical data were incomplete, participants were contacted via telephone to obtain the missing information. Verbal informed consent was obtained from all participants prior to data collection. All necessary ethical considerations, including data confidentiality and adherence to both institutional and international ethical standards, were strictly followed.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Data sharing statement: The data presented in this study are available on request from the corresponding author. The data are not publicly available due to patients’ privacy restrictions.
Corresponding author: Klaita Srisingh, Associate Professor, Department of Pediatrics, Naresuan University, 99 Moo 9, Phitsanulok-Nakhonsawan Road, Thapho Subdistrict, Phitsanulok 65000, Thailand. klaitas@nu.ac.th
Received: August 26, 2025 Revised: November 7, 2025 Accepted: November 27, 2025 Published online: March 9, 2026 Processing time: 193 Days and 4.8 Hours
Abstract
BACKGROUND
Recurrent wheezing following acute lower respiratory tract infection (ALRTI) in early childhood is a common clinical problem and may be an early indicator of chronic respiratory diseases. Early identification of associated risk factors is essential for early intervention and prevention.
AIM
To investigate the risk factors and timing of recurrent wheezing episodes following ALRTI in children.
METHODS
A retrospective cohort study was conducted among pediatric patients ≤ 5 years old admitted with ALRTI and wheezing at Naresuan University Hospital between July 1, 2020 and June 30, 2023. Participants were followed for 12 months. Data from electronic and paper records were analyzed using STATA 18.0. Multivariable logistic regression identified independent risk factors. Kaplan-Meier analysis and log-rank tests compared recurrence and non-recurrence groups through survival curves.
RESULTS
Significant predictors of recurrent wheezing included age 12-24 months [odds ratio (OR): 2.38; 95%CI: 1.50-3.78, P < 0.001], prematurity (OR: 1.66; 95%CI: 1.07-2.58, P = 0.024), allergic rhinitis (OR: 1.50; 95%CI: 1.04-2.17, P = 0.031), urban residency (OR: 1.68; 95%CI: 1.19-2.38, P = 0.003), eosinophilia (absolute eosinophil count > 500 cells/μL) (OR: 3.29; 95%CI: 1.57-6.91, P = 0.002), and prior lower respiratory tract infection (OR: 1.82; 95%CI: 1.20-2.76, P = 0.005). The median time to recurrence was 100 days (interquartile range: 43-125), varying across clinical and environmental subgroups.
CONCLUSION
Children with certain demographic and clinical features have higher recurrent wheezing risk after ALRTI, highlighting the need for closer monitoring and early preventive care.
Core Tip: This study examined children hospitalized with acute lower respiratory tract infections and wheezing, identifying several independent risk factors for recurrent wheezing, including age 12-24 months, prematurity, allergic rhinitis, urban residence, eosinophilia, and prior lower respiratory tract infection. Notably, the median time to recurrence was 100 days, providing practical insight for optimizing follow-up timing and early intervention strategies.
