A60-01 Prevalence of Preschool Asthma Among Children With Early Life SARS-CoV-2 Infection

Abstract Rationale Early life infection with respiratory viruses such as rhinovirus, respiratory syncytial virus, and human metapneumovirus is strongly associated with subsequent diagnosis of childhood asthma. However, it remains unknown if early life infection with SARS-CoV-2, which was first identified in late 2019, is similarly a risk factor for childhood asthma. We sought to determine what proportion of children with early life SARS-CoV-2 infection developed asthma by preschool age. Methods We conducted a retrospective chart review study using the Western Pennsylvania COVID-19 Registry, which included children aged 0-21 years seen at UPMC Children’s Hospital of Pittsburgh or Children’s Community Pediatrics who had been diagnosed with SARS-CoV-2 from 2020-2022 (n = 3,120). We reviewed the electronic health records (EHR) of children aged 0-3 years at the time of SARS-CoV-2 infection (n = 542) through June 2025 for a subsequent diagnosis of asthma. We defined asthma by: 1) a J45 ICD-10 code (which includes asthma or reactive airway disease) or 2) two or more documented episodes of wheezing with clinical response to a bronchodilator. We also extracted information on participants’ medical and family history. We conducted bivariate analysis by asthma diagnosis. Results We screened 144 registry participants whose infection occurred between April 2020 and December 2021. Of these 144, 141 were seen for another medical encounter in our EHR after their COVID-19 diagnosis, and 137 had sufficient documentation to review for asthma. Of these 137, 59 (43%) were female and the median age at most recent follow-up encounter was 5 years. We found that 22 (16.1%) had asthma and 115 (83.9%) did not have asthma. Compared to children without a diagnosis of asthma, those who developed asthma were more likely to have a family history of asthma (26.3% versus 4.5%, p 0.001) and a personal history of pneumonia (27.3% versus 3.5%, p 0.001) and documented history of wheezing (68.2% versus 20.0%, p 0.001). Conclusion In this preliminary analysis, we found that the prevalence of preschool asthma in children with early life SARS-CoV-2 infection seen at our medical center was 16.1%; the reported prevalence of asthma in children ages 0-4 in Allegheny County, where our medical center is located, is 5%. Our preliminary findings suggest that early life SARS-CoV-2 infection may be associated with increased likelihood of preschool asthma. Continuing chart review for the remaining 398 registry participants will allow us to increase our sample size and further investigate the associations using multivariable analysis. This abstract is funded by: NIH