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Published on: August 7, 2017

Bidirectional changes in recorded pediatric asthma diagnoses with respiratory virus activity: A nationwide

Naomi Matsumoto1, Hisashi Ishida2, Shunsaku Hayase3

  • 1Department of Epidemiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.

Allergology International : Official Journal of the Japanese Society of Allergology
|August 14, 2026
PubMed

Insights

Early-life respiratory infections may contribute to pediatric asthma. COVID-19 non-pharmaceutical interventions (NPIs) reduced respiratory viruses and asthma diagnoses, with asthma incidence rebounding as NPIs relaxed.

Area of Science:

  • Pediatric respiratory health
  • Epidemiology of infectious diseases
  • Asthma research

Background:

  • Early-life respiratory infections are linked to asthma development.
  • The role of respiratory viruses in asthma onset versus unmasking susceptibility is unclear.
  • The COVID-19 pandemic provided a natural experiment with non-pharmaceutical interventions (NPIs) suppressing and then allowing respiratory virus resurgence.

Purpose of the Study:

  • To investigate the association between population-level changes in respiratory virus activity and pediatric asthma diagnoses.
  • To examine the impact of COVID-19 NPIs and their relaxation on new pediatric asthma diagnoses.
  • To assess the role of specific respiratory pathogens in pediatric asthma incidence.

Main Methods:

  • A nationwide interrupted time-series study in Japan using health insurance claims data (approx. 99% population coverage).
  • Segmented negative binomial regression analyzed monthly asthma diagnoses in children under 19 (Jan 2018-Mar 2024), with atopic dermatitis as a negative control.
  • Analyses included age/sex stratification and ecological associations with specific pathogens.

Main Results:

  • Newly recorded pediatric asthma diagnoses significantly declined after NPI implementation (IRR 0.511) and rebounded after NPI relaxation (IRR 1.395).
  • Atopic dermatitis showed less pronounced changes, suggesting specificity to asthma.
  • Rate differences were most significant in infants (0-1 years) post-NPI and school-aged children (5-9 years) post-NPI relaxation. Rhinovirus, RSV, influenza, and M. pneumoniae correlated with asthma diagnoses.

Conclusions:

  • Pediatric asthma diagnoses exhibited bidirectional changes mirroring respiratory virus suppression and resurgence.
  • Findings support a potential contributory role of respiratory infections in pediatric asthma development.
  • Infants and school-aged children appear particularly susceptible to these effects.
Abstract

Keywords:
AsthmaCOVID-19Interrupted time seriesRespiratory syncytial virusRhinovirus

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