Abstract Background Medically attended respiratory infections (MARI) are defined as respiratory infections that require medical care. In individuals with pulmonary disease, MARI have been associated with increased pneumonia, hospital admissions, and emergency department visits. However, the clinical consequence of outpatient respiratory illnesses in persons without pulmonary disease has not been established. To investigate this, we examined medical diagnoses and healthcare utilization after MARI in 2018. Methods The electronic medical record was queried to identify adults (age 18 or above) with outpatient or emergency department encounters with ICD-10 codes matching respiratory infections from January 1, 2018 to December 31, 2018. Individuals with previous diagnosis of pulmonary disease (asthma, COPD, bronchiectasis, interstitial lung disease, and pulmonary hypertension) or malignancy were excluded. Recurrent MARI was defined as an outpatient or emergency department encounter with a qualifying MARI diagnosis occurring 60 to 180 days after the initial MARI event. Healthcare encounters and medical diagnoses were collected for 5 years after the MARI event. A logistic regression model was employed to determine the relationship between recurrent MARI and new disease diagnoses. A Poisson regression model was used to determine the relationship between recurrent MARI and number of healthcare encounters. Regression models were adjusted for sex, age, race, ethnicity, smoking status, number of healthcare encounters 5 years before index MARI event, and pre-MARI medical diagnoses (hypertension, hyperlipidemia, diabetes, coronary artery disease, obesity, and inhaler use). Results 48474 individuals had qualifying MARI events and 3345 (6.9%) had recurrent MARI. The most common MARI events were acute pharyngitis (J02.9, 35.1%), acute URI (J06.9, 27.5%), and streptococcal pharyngitis (J02.0, 8.5%). Mean age at first MARI event was 34.1 (standard deviation (SD) 9.1). Individuals with MARI were predominantly female (30500, 62.9%), white (36471, 75.2%), not Hispanic or Latino/a (40996, 84.6%), and never smokers (36369, 75%). As seen in table 1, individuals with recurrent MARI had significantly increased odds of newly diagnosed asthma, chronic obstructive pulmonary disease, interstitial lung disease, pulmonary embolism, and venous thromboembolic disease (VTE), compared to those with nonrecurrent MARI. Healthcare utilization was higher in persons with recurrent MARI. Conclusions In individuals without previously diagnosed chronic respiratory disease, recurrent medically attended respiratory infections are associated with increased incidence of lung disease, VTE, and pulmonary embolism diagnoses after infection. Individuals with recurrent MARI also have higher healthcare utilization rates. This study suggests recurrent respiratory infections carry significant long-term morbidity. Further studies should investigate mechanisms of long-term health effects of respiratory infections. This abstract is funded by: ALA Airways Clinical Research Centers PILOT award
Bailey et al. (Fri,) studied this question.