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Published on: November 7, 2020
COVID-19 and Asthma Onset in Children
James P Senter1, Laura K Aisenberg1, Jesse W Dudley2
1Departments of Pediatrics.
Insights
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection did not increase the risk of new asthma diagnoses in children. This study confirms known pediatric asthma risk factors, informing care for children with SARS-CoV-2 history.
Area of Science:
- Pediatric respiratory health
- Infectious disease epidemiology
- Asthma research
Background:
- Respiratory viral infections are known asthma triggers in children.
- Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can cause severe respiratory illness.
- The impact of SARS-CoV-2 on new pediatric asthma diagnoses requires investigation.
Purpose of the Study:
- To determine if SARS-CoV-2 infection influences the risk of new-onset asthma in children.
- To analyze the association between SARS-CoV-2 positivity and incident asthma diagnoses.
- To identify risk factors for asthma development in children with and without SARS-CoV-2 exposure.
Main Methods:
- Retrospective cohort study of children aged 1-16 years.
- Analysis of polymerase chain reaction (PCR) test results for SARS-CoV-2.
- Multivariable Cox regression models adjusted for demographics, socioeconomic factors, and atopic conditions.
Main Results:
- SARS-CoV-2 PCR positivity showed no significant association with new asthma diagnosis (HR: 0.96, P = .79).
- Black race, food allergies, and allergic rhinitis were significant risk factors for new asthma diagnoses.
- Preterm birth and BMI increased asthma risk in children under 5 years old.
Conclusions:
- SARS-CoV-2 infection was not linked to new asthma diagnoses in children during the study period.
- Established risk factors for pediatric asthma were confirmed.
- Findings provide insights into the prognosis and care of children post-SARS-CoV-2 infection.
Background And Objectives:
Respiratory viral infections increase risk of asthma in infants and children. Infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus can cause severe lung inflammation and prolonged respiratory symptoms. We sought to determine whether SARS-CoV-2 infection modified pediatric incident asthma risk.
Methods:
This retrospective cohort study examined children ages 1 to 16 within the Children's Hospital of Philadelphia Care Network who received polymerase chain reaction (PCR) testing for SARS-CoV-2 between March 1, 2020 and February 28, 2021. Multivariable Cox regression models assessed the hazard ratio of new asthma diagnosis between SARS-CoV-2 PCR positive and SARS-CoV-2 PCR negative groups within an 18-month observation window. Models were adjusted for demographic characteristics, socioeconomic variables, and atopic comorbidities.
Results:
There were 27 423 subjects included in the study. In adjusted analyses, SARS-CoV-2 PCR positivity had no significant effect on the hazard of new asthma diagnosis (hazard ratio [HR]: 0.96; P = .79). Black race (HR: 1.49; P = .004), food allergies (HR: 1.26; P = .025), and allergic rhinitis (HR: 2.30; P < .001) significantly increased the hazard of new asthma diagnosis. Preterm birth (HR: 1.48; P = .005) and BMI (HR: 1.13; P < .001) significantly increased the hazard of new asthma diagnosis for children <5 years old.
Conclusions:
SARS-CoV-2 PCR positivity was not associated with new asthma diagnosis in children within the observation period, although known risk factors for pediatric asthma were confirmed. This study informs the prognosis and care of children with a history of SARS-CoV-2 infection.
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