Study: Asthma Diagnosis in Children Does Not Appear Linked to COVID-19 Diagnosis

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According to results published in Pediatrics, testing positive for COVID-19 was not found to be increase the risk new asthma diagnoses in pediatric patients. Respiratory viral infections in early life are risk factors for an asthma diagnosis, and because COVID-19 can result in severe lung inflammation or prolonged respiratory symptoms in some patients, researchers investigated whether COVID-19 symptoms might have a similar effect in children.¹

“During the early days of the pandemic, we could isolate the effects of COVID-19 from other viruses and follow these patients long enough to observe the onset of asthma,” said first study author James P. Senter, MD, MPH, attending physician in the department of pediatrics at the Children’s Hospital of Philadelphia (CHOP), in a press release. “We were also testing so frequently that we had a built-in control group to compare asthma symptoms and whether COVID-19 was a critical factor.”¹

The retrospective cohort study enrolled 27,423 pediatric patients aged 1 to 16 years of age within the CHOP care network who received a polymerase chain reaction (PCR) test for SARS-CoV-2 between March 1, 2020, to February 28, 2021. The risk of new asthma diagnosis between positive PCR and negative PCR groups were observed over an 18-month duration, and if necessary, models were adjusted for demographics, socioeconomic variables, and atopic comorbidities.²

Among the 27,423 patients enrolled in the study, 3147 (11.5%) tested positive for COVID-19 whereas the remaining patients were negative. According to the analysis, patients who tested positive were more likely to be older, Black, insured by Medicaid, and have a higher body mass index. Individuals who tested positive were also more likely to have an allergic rhinitis diagnosis and less likely to have a food allergy diagnosis.²

A total of 573 patients received an asthma diagnosis during the 18-month follow-up period, and of these patients, the researchers found that 57 patients (1.81%) who tested positive for SARS-CoV-2 were later diagnosed with asthma, compared with 2.13% of SARS-CoV-2-negative patients (n = 516). According to the researchers, regression analyses demonstrated that being positive for COVID-19 did not have an association with the hazard of new asthma diagnoses during the follow-up period (HR: 0.96; 95% CI: 0.73–1.27). In addition, Black patients (HR: 1.49; 95% CI: 1.13–1.95), comorbid food allergies (HR: 1.26; 95% CI: 1.03–1.55), and allergic rhinitis (HR: 2.30; 95% CI: 1.93–2.74) were associated with a higher risk of new asthma diagnosis; however older age (ages 5–11: HR: 0.27; 95% CI: 0.22–0.34; ages 12+: HR: 0.16; 95% CI: 0.12–0.22) was not.²

The authors emphasize that more research needs to be conducted to determine whether the findings are consistent with adult patients. Despite the emergence of new COVID-19 variants since the study was first conducted, many of the vital elements of the original virus—which appear to reduce the allergic response that is produced in patients—have remained consistent in the current variants.¹

“This well-powered study reaffirms risk factors we know contribute to asthma development and provides clinically useful information to pediatricians and providers on the absence of risk of developing asthma as a result of COVID-19,” said senior study author David A. Hill, MD, PhD, attending physician in the division of allergy and immunology at CHOP, said in the press release. “We are hopeful that this study will put to rest an outstanding question on the minds of many their families.”¹

References

1. Children’s Hospital of Philadelphia. Researchers find no link between COVID-19 virus and development of asthma in children. News release. April 12, 2024. Accessed April 12, 2024. https://www.eurekalert.org/news-releases/1040818

2. Senter, JP, Aisenberg, LK, Dudley, JW, et al. Hill; COVID-19 and Asthma Onset in Children. Pediatrics 2024; e2023064615 doi:10.1542/peds.2023-064615