Co-occurrence and multi-system clustering of respiratory and allergic symptoms in Polish school-aged children: a Global Asthma Network cross-sectional study.

PURPOSE: Allergic and asthma-related respiratory symptoms frequently co-occur in childhood and may reflect shared inflammatory mechanisms. However, population-based data on their overlap in Central and Eastern Europe remain limited.

METHODS

We conducted a cross-sectional analysis of 1293 children aged 5-9 years from the Polish arm of the Global Asthma Network survey. Respiratory symptoms included wheeze, exercise-induced wheeze, and cough unrelated to infection. Allergic symptoms included nasal symptoms, itchy/watery eyes, and rash. Symptom-domain presence was defined as ≥1 symptom, and multi-symptom clustering as ≥2 symptoms per domain. Associations were assessed using χ2 tests and multivariable logistic regression adjusted for age, sex, and parental asthma.

RESULTS

Respiratory symptom-domain presence was observed in 20.3% of children and allergic symptom-domain presence in 40.8%; 11.6% had both. Children with allergic symptoms were more likely to have respiratory symptoms (28.4% vs 14.8%, p < 0.001). Respiratory and allergic symptom domains were strongly associated in adjusted models (aOR 2.16, 95% CI 1.63-2.86). Using stricter ≥2 symptom definitions, the association increased markedly (respiratory clustering aOR 10.20; allergic clustering aOR 9.91; both p < 0.001). Parental asthma was associated with allergic symptoms (aOR 1.79, p = 0.002) and respiratory clustering (aOR 3.87, p = 0.002), but no significant interaction was observed.

CONCLUSIONS

Respiratory and allergic symptoms commonly co-occur in children, particularly among those with higher symptom burden. Integrated assessment across symptom domains may improve recognition of children who could benefit from further primary care or specialist evaluation, particularly in the context of parental asthma.