COVID-19 Not Associated With Increased Risk of Asthma Development in Children


A study from the Children’s Hospital of Philadelphia found that a positive PCR test was not associated with an increased risk of a new asthma diagnosis in patients ages 1 to 16.

An infection with the SAR-COV-2 virus does not increase the risk of asthma development in pediatric patients, according to data published in the journal Pediatrics.1 The study authors noted that the research could be useful in the prognosis and treatment of long-term respiratory effects of COVID-19 in children.

A SARS-CoV-2 infection does not increase asthma development risk in pediatric patients. / Microgen -

A SARS-CoV-2 infection does not increase asthma development risk in pediatric patients. / Microgen -

Respiratory virus infections—such as COVID-19—are known to increase the risk of asthma development in children. Prior research has found that children who were hospitalized with COVID-19 had a higher incidence of chronic cough and asthma-like symptoms. However, there is currently a lack of data on the incidence of an asthma diagnosis in pediatric patients after a COVID-19 infection.

Key Takeaways

  • Research published in Pediatrics suggests that pediatric patients infected with SARS-CoV-2 do not face a higher risk of developing asthma.
  • A retrospective cohort study at the Children’s Hospital of Philadelphia analyzed records of over 27,000 children aged 1 to 16 who underwent SARS-CoV-2 PCR testing. Results showed a slightly lower incidence of new asthma diagnoses among SARS-CoV-2-positive patients compared to negative ones over an 18-month follow-up.
  • While providing valuable insights, the study underscores the need for further research to fully understand COVID-19’s impact on asthma development in children. Limitations include reliance on data from a single institution and lack of consideration for COVID-19 severity.

Investigators from the Children’s Hospital of Philadelphia conducted a retrospective cohort study to determine whether an infection with SARS-CoV-2 modified pediatric incident asthma risk. The study was funded by the National Institutes of Health and the Children’s Hospital of Philadelphia Research Institute.

“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,” James P. Senter, MD, MPH, first author on the study, said in a release.2 “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.”

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Data for the study was gathered from electronic health records from the Children’s Hospital of Philadelphia Care Network. The study cohort included 27423 patients aged between 1 and 16 who received a polymerase chain reaction (PCR) test for SARS-CoV-2 between March 1, 2020, and February 28, 2021. Study participants were required to have at least 1 ambulatory well child visit in the year prior to the PCR test and at least 1 visit any time during 18-months of follow-up after the first positive or last negative PCR test.

Of the study participants, 3146 were in the SARS-CoV-2 positive group and 24276 were in the negative group. Patients who tested positive were more likely to be older, Black, have a higher BMI, be insured by Medicaid, and were among lower childhood opportunity index quintiles. SARS-CoV-2 positive patients were also less likely to have food allergies but more likely to have allergic rhinitis.

Investigators found that 573 patients received an asthma diagnosis in the 18-month follow-up period. Of patients who tested positive for SARS-CoV-2, 1.81% were subsequently diagnosed with asthma, compared to 2.13% of SARS-CoV-2 negative patients. For most of the follow-up, patients with SARS-CoV-2 had a lower incidence of new asthma diagnosis compared to SARS-CoV-2 negative patients.

During the 18-month follow-up, a positive PCR test was not associated with an increased risk of new asthma diagnosis. Additionally, Black race, comorbid food allergy, and allergic rhinitis were associated with a significantly increased risk of new asthma diagnosis during the study period.

Study limitations included the use of data from only 1 institution, a reliance upon SARS-CoV-2 PCR test results for a 1-year exposure window, and using an exposure window that came before new variants of SARS-CoV-2. The investigators said that future studies should consider COVID-19 infection severity which may modify incident asthma risk in pediatric patients.

“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,” David A. Hill, MD, PhD, senior author on the study, said in a release.2 “We are hopeful that this study will put to rest an outstanding question on the minds of many their families.”

READ MORE: Infectious Disease Resource Center

1. Senter JP, Aisenberg LK, Dudley JW, et al. COVID-19 and Asthma Onset in Children. Pediatrics 2024; e2023064615. 10.1542/peds.2023-064615
2. Researchers Find No Link Between COVID-19 Virus and Development of Asthma in Children. News Release. Children’s Hospital of Philadelphia. April 12, 2024. Accessed April 15, 2024.
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