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Navigating Change: A Comparative Study on Pediatric Asthma Care Before and After COVID-19

Natasha Chaudhari1, Joanne Nazif2,3, Eunah Song2

  • 1Children's Hospital of Philadelphia, Philadelphia, PA, USA.

Clinical Pediatrics
|March 1, 2026
PubMed

Insights

Pediatric asthma admissions returned to pre-pandemic levels post-COVID-19. However, the average length of stay (LOS) decreased, suggesting potentially less severe cases, which could lower healthcare costs.

Area of Science:

  • Pediatric Pulmonology
  • Epidemiology
  • Infectious Disease

Background:

  • Viral illnesses commonly trigger pediatric asthma exacerbations, leading to higher hospital admission rates during influenza season.
  • Previous research indicated a decrease in asthma admissions during the COVID-19 pandemic, with a concurrent increase in patient acuity.
  • The long-term impact of the COVID-19 pandemic on pediatric asthma hospitalization trends requires further investigation.

Purpose of the Study:

  • To analyze trends in pediatric asthma admissions and severity one year after the initial COVID-19 outbreak.
  • To compare hospitalization data from pre-pandemic, pandemic, and post-pandemic periods.
  • To identify factors influencing length of stay (LOS) as a proxy for asthma severity.

Main Methods:

  • A retrospective cohort study comparing pediatric asthma admissions at a Bronx children's hospital.
  • Data collected from October through May across three cohorts: 2019-2020 (pre-pandemic), 2020-2021 (COVID-19), and 2021-2022 (post-COVID-19).
  • Length of stay (LOS) was utilized to approximate asthma severity; statistical analysis was performed to compare cohorts.

Main Results:

  • Total admissions in the post-COVID-19 cohort (318) approached pre-pandemic levels (320), significantly higher than the COVID-19 cohort (112).
  • Mean LOS decreased from 2.4 days pre-pandemic to 2.0 days post-COVID-19 (P = .0004).
  • The COVID-19 cohort showed increased likelihood of receiving magnesium sulfate and intensive care (P = .02, P = .0007).

Conclusions:

  • Pediatric asthma admissions have returned to pre-pandemic frequencies.
  • A reduction in mean length of stay post-COVID-19 suggests a potential decrease in asthma severity or changes in management.
  • Further research into the factors contributing to the decreased LOS could inform strategies for reducing healthcare costs associated with pediatric asthma.

Keywords:
BronxCOVID-19admission ratesflu seasonlength of stay (LOS)pediatric asthmatripledemic

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