Yang Chiao-Yu, Shih Yu-Hsiang, Lung Chia-Chi
Department of Occupational Health Nursing Center, Institute of Public Health, Chung Shan Medical University Hospital, Taichung City, Taiwan.
Department of Public Health, Chung Shan Medical University, No. 110, Sec. 1 Jianguo N.Rd., Taichung City, 40201, Taiwan.
Infection. 2025 Feb;53(1):125-137. doi: 10.1007/s15010-024-02329-3. Epub 2024 Jun 21.
The COVID-19 pandemic has underscored the importance of its potential long-term health effects, including its link to new-onset asthma in children. Asthma significantly impacts children's health, causing adverse outcomes and increased absenteeism. Emerging evidence suggests a potential association between COVID-19 infection and higher rates of new-onset asthma in adults, raising concerns about its impact on children's respiratory health.
A retrospective cohort study design was employed, using electronic medical records from the TriNetX database, covering January 1, 2021, to December 31, 2022. Two cohorts of children aged 5 to 18 who underwent SARS-CoV-2 RT-PCR testing were analyzed: unvaccinated children with and without COVID-19 infection, and vaccinated children with and without infection. Propensity score matching was used to mitigate selection bias, and hazard ratio (HR) and 95% CI were calculated to assess the risk of new-onset asthma.
Our study found a significantly higher incidence of new-onset asthma in COVID-19 infected children compared to uninfected children, regardless of vaccination status. In Cohort 1, 4.7% of COVID-19 infected children without vaccination developed new-onset asthma, versus 2.0% in their non-COVID-19 counterparts within a year (HR = 2.26; 95% CI = 2.158-2.367). For Cohort 2, COVID-19 infected children with vaccination showed an 8.3% incidence of new-onset asthma, higher than the 3.1% in those not infected (HR = 2.745; 95% CI = 2.521-2.99). Subgroup analyses further identified higher risks in males, children aged 5-12 years, and Black or African American children. Sensitivity analyses confirmed the reliability of these findings.
The study highlights a strong link between COVID-19 infection and an increased risk of new-onset asthma in children, which is even more marked in those vaccinated. This emphasizes the critical need for ongoing monitoring and customized healthcare strategies to mitigate the long-term respiratory impacts of COVID-19 in children, advocating for thorough strategies to manage and prevent asthma amidst the pandemic.
新冠疫情凸显了其潜在长期健康影响的重要性，包括其与儿童新发哮喘的关联。哮喘严重影响儿童健康，导致不良后果并增加缺勤率。新出现的证据表明，新冠病毒感染与成人中更高的新发哮喘发病率之间可能存在关联，这引发了人们对其对儿童呼吸健康影响的担忧。
采用回顾性队列研究设计，使用TriNetX数据库中2021年1月1日至2022年12月31日的电子病历。对两组年龄在5至18岁且接受过新冠病毒逆转录聚合酶链反应（RT-PCR）检测的儿童进行分析：未接种疫苗且感染新冠病毒的儿童、未接种疫苗且未感染新冠病毒的儿童、接种疫苗且感染新冠病毒的儿童以及接种疫苗且未感染新冠病毒的儿童。使用倾向得分匹配来减轻选择偏倚，并计算风险比（HR）和95%置信区间（CI）以评估新发哮喘的风险。
我们的研究发现，无论疫苗接种状况如何，感染新冠病毒的儿童中新发哮喘的发病率显著高于未感染儿童。在队列1中，4.7%未接种疫苗且感染新冠病毒的儿童在一年内出现了新发哮喘，而未感染新冠病毒的儿童这一比例为2.0%（HR = 2.26；95% CI = 2.158 - 2.367）。对于队列2，接种疫苗且感染新冠病毒的儿童中新发哮喘的发病率为8.3%，高于未感染儿童的3.1%（HR = 2.745；95% CI = 2.521 - 2.99）。亚组分析进一步确定，男性、5至12岁儿童以及黑人或非裔美国儿童的风险更高。敏感性分析证实了这些发现的可靠性。
该研究突出了新冠病毒感染与儿童新发哮喘风险增加之间的紧密联系，在接种疫苗的儿童中更为明显。这强调了持续监测和定制医疗保健策略以减轻新冠病毒对儿童长期呼吸影响的迫切需求，倡导在疫情期间采取全面的策略来管理和预防哮喘。
