# Effects of COVID-19 pandemic–associated reduction in respiratory infections on infantile asthma development

## TL;DR

Reduced respiratory infections during the pandemic were linked to lower asthma rates in infants, but effects faded by age 3.

## Contribution

Shows early-life infection reduction may lower asthma risk in young children.

## Key findings

- At 18 months, pandemic infants had significantly lower asthma/asthmatic bronchitis rates than nonpandemic infants.
- By age 3, asthma rates in pandemic infants increased but were still lower after RSV infection compared to nonpandemic infants.
- RSV infection after 18 months had little effect on asthma onset in pandemic infants.

## Abstract

It is speculated that the coronavirus disease 2019 (COVID-19) pandemic–associated reduction in the prevalence of respiratory tract infections has influenced the incidence of asthma in young children.

We investigated an association between the reduction in viral infections and the reduction in asthma in young children.

The subjects were infants born in the early stages of the COVID-19 pandemic in Japan, which began in February 2020. A questionnaire survey related to asthma and allergy was conducted at 18 months and 3 years of age. These results were compared to those of age-matched infants during the nonpandemic period.

There were no epidemics of viral infectious diseases until the target child was 18 months old. At 18 months, the incidence of asthma/asthmatic bronchitis diagnosed by physicians in pandemic children was significantly lower than that in nonpandemic children. In 3-year-olds, no marked difference was observed between nonpandemic infants and pandemic children, except for an increase in respiratory syncytial virus infection in pandemic children. In a comparative study of the same children at ages 18 months and 3 years, an increased prevalence of asthma/asthmatic bronchitis was observed in pandemic children. Furthermore, the incidence of asthma after respiratory syncytial virus infection in pandemic infants was significantly lower than that in nonpandemic children.

The COVID-19 pandemic–associated reduction in respiratory tract infections may have reduced the incidence of asthma in early childhood, and respiratory syncytial virus infection after 18 months of age had little effect on the onset of asthma. These results indicate the importance of preventing respiratory tract infections in early infancy.