Related Experiment Video
Updated: Oct 13, 2025
Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma
Published on: November 4, 2010
Asthma as a risk factor for hospitalization in children with COVID-19: A nested case-control study
Kristina Gaietto1, Megan Culler Freeman2, Leigh Anne DiCicco3
1Division of Pulmonary Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Insights
In children, asthma increases the risk of hospitalization with COVID-19 (coronavirus disease 2019). However, asthma does not worsen COVID-19 outcomes or trigger exacerbations in pediatric patients.
Area of Science:
- Pediatric respiratory health
- Infectious disease epidemiology
- Clinical research
Background:
- Previous pediatric asthma and COVID-19 studies were limited by their ecological design.
- This study investigated the individual-level association between asthma and COVID-19 in children.
Purpose of the Study:
- To evaluate the association between asthma and COVID-19 in children at an individual level.
- To determine if asthma is a risk factor for severe COVID-19 outcomes in pediatric populations.
Main Methods:
- A nested case-control study was conducted using prospective clinical registry data.
- Three groups were compared: children with COVID-19 and asthma (A+C cases), children with COVID-19 without asthma (C+ controls), and children with asthma without COVID-19 (A+ controls).
Main Results:
- Children with asthma and COVID-19 (A+C) were more likely to present with dyspnea, wheezing, receive systemic steroids, and be hospitalized compared to children with COVID-19 alone (C+).
- Asthma was associated with a nearly 4-fold increased risk of hospitalization in children with COVID-19 (adjusted OR = 3.95).
- However, asthma severity was not linked to worse COVID-19 outcomes, and SARS-CoV-2 did not appear to be a strong trigger for pediatric asthma exacerbations.
Conclusions:
- Asthma is a significant risk factor for hospitalization in children diagnosed with COVID-19.
- COVID-19 infection does not appear to lead to worse outcomes in children with asthma.
- SARS-CoV-2 is not a potent trigger for pediatric asthma exacerbations.
Background:
Most pediatric studies of asthma and COVID-19 to date have been ecological, which offer limited insight. We evaluated the association between asthma and COVID-19 at an individual level.
Methods:
Using data from prospective clinical registries, we conducted a nested case-control study comparing three groups: children with COVID-19 and underlying asthma ("A+C" cases); children with COVID-19 without underlying disease ("C+" controls); and children with asthma without COVID-19 ("A+" controls).
Results:
The cohort included 142 A+C cases, 1110 C+ controls, and 140 A+ controls. A+C cases were more likely than C+ controls to present with dyspnea and wheezing, to receive pharmacologic treatment including systemic steroids (all p < .01), and to be hospitalized (4.9% vs. 1.7%, p = .01). In the adjusted analysis, A+C cases were nearly 4 times more likely to be hospitalized than C+ controls (adjusted OR = 3.95 [95%CI = 1.4-10.9]); however, length of stay and respiratory support level did not differ between groups. Among A+C cases, 8.5% presented with an asthma exacerbation and another 6.3% developed acute exacerbation symptoms shortly after testing positive for SARS-CoV-2. Compared to historic A+ controls, A+C cases had less severe asthma, were less likely to be on controller medications, and had better asthma symptom control (all p < .01).
Conclusions:
In our cohort, asthma was a risk factor for hospitalization in children with COVID-19, but not for worse COVID-19 outcomes. SARS-CoV-2 does not seem to be a strong trigger for pediatric asthma exacerbations. Asthma severity was not associated with higher risk of COVID-19.
More Related Videos
Related Concept Videos
01:29Asthma-I: Introduction
01:20Asthma: Pathogenesis and Management
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.
01:24Asthma-III: Symptoms and Complications
Classification of Asthma
01:26Asthma-II: Pathophysiology and Classification
Additionally, environmental and genetic factors play crucial roles in determining an individual's susceptibility to asthma and the severity of their condition.
Critical processes in asthma pathophysiology include:
01:30Asthma-IV: Diagnostic and Management
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
01:30Asthma-IV: Nursing Management
First, in...