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Review
. 2025 Aug;13(8):1952-1959.
doi: 10.1016/j.jaip.2025.04.056. Epub 2025 May 14.

Evaluating the Impact of the COVID-19 Pandemic on Pediatric Asthma Incidence

Ashley L Devonshire  1 , Theresa Guilbert  2 , Cindy S Bauer  3 , Heidi Schmidt  3 , Stephanie Davis  4 , Michelle Hernandez  4 , Anne M Fitzpatrick  5 , Jonathan M Gaffin  6 , Meyer Kattan  7 , Aliva De  7 , Daniel J Jackson  8 , David Mauger  9 , Wanda Phipatanakul  10 , Justin T Schwartz  11 , William Sheehan  12 , Dayna Long  13 , Lourdes Juarez  13 , Leonard B Bacharier  14 , Jeffrey R Stokes  15 , Stephen J Teach  12 , Wayne J Morgan  16 , Fernando D Martinez  16 ; ORBEX, a multicenter clinical trial network funded by the National Heart, Lung, and Blood Institute
Affiliations
Review

Evaluating the Impact of the COVID-19 Pandemic on Pediatric Asthma Incidence

Ashley L Devonshire et al. J Allergy Clin Immunol Pract. 2025 Aug.

Abstract

Multiple early life environmental exposures are thought to influence childhood asthma incidence. The coronavirus disease 2019 (COVID-19) pandemic resulted in changes in air pollution levels and a marked disruption in the circulation of childhood respiratory viruses. Both air pollution and respiratory viruses have been implicated in the development of asthma and early childhood wheeze. Human behavior and daily routine practices, including family gatherings and daycare attendance, were impacted profoundly by the COVID-19 pandemic and the associated mitigation measures. The changes to human behavior and social interactions that occurred during the pandemic have and will likely continue to impact chronic diseases, including the development of asthma. This rostrum explores how childhood asthma incidence might be affected by the COVID-19 pandemic and its associated public health mitigation measures. Recently completed and ongoing clinical trials being conducted in the infant and toddler population and assessing allergic outcomes may be well positioned to examine the impact of the pandemic on asthma incidence and time to asthma onset.

Keywords: Allergy; Asthma; COVID-19 pandemic; Mitigation; Prevention; Respiratory infection.

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Conflict of interest statement

Conflicts of Interest:

ALD: Reports grants or contracts from the National Institutes of Health (NIH), Sanofi, GlaxoSmithKline (GSK), OM Pharma and Food Allergy Research and Education (FARE); consulting fees from Genentech; support for meeting attendance and/or travel from the American Academy of Allergy, Asthma, and Immunology (AAAAI) and FARE.

TG: Reports grants or contracts from GSK, Sanofi/Regeneron/Amgen, AstraZeneca, and OM Pharma; royalties or licenses from UpToDate; consulting fees from Sanofi, Regeneron, AstraZeneca, Genentech, Polarean, and OM Pharma; personal fees from Sanofi, Regeneron, AiCME, PlatformQ Health, and Advent; support for meeting attendance and/or travel from AiCME, PlatformQ Health, and Advent; participation on a data safety monitoring board (DSMB) or advisory board for Best Pharmaceuticals for Children Act (BPCA).

CSB: Reports grants or contracts from NIH/NHLBI and OM Pharma.

HS: Nothing to disclose.

SD: Reports grants or contracts from NIH; serves as Vice Chair and Chair of Publications Policy Committee for the American Thoracic Society.

MH: Reports consulting fees from GSK.

AMF: Nothing to disclose.

JMG: Reports grants or contracts from Vertex, GSK and AstraZeneca; payment for expert testimony from Dudley & Lake, LLC, Evans, Craven & Lackie, P.S., Panish | Shea | Boyle | Ravipudi LLP; payment for participation on DSMB or Advisory Board for Syneos Health.

MK: Nothing to disclose.

AD: Nothing to disclose.

DJJ: Reports grants or contracts from NIAID and NHLBI; consulting fees from Areteia, Avillion, AstraZeneca, GSK, Genentech, Regeneron, Sanofi; participation in DSMB or Advisory Board for Pfizer, Upstream Bio, and AstraZeneca.

DM: Nothing to disclose.

WP: Reports grants or contracts from NIH and OM Pharma; consulting fees from Genentech, Novartis, Sanofi, Regeneron, GSK, and AstraZeneca.

JTS: Reports consulting feeds from Regeneron and Takeda; personal fees from Mayo Clinic and the Michigan Allergy Society.

WS: Reports grants or contracts from NIH and Merck; consulting fees from Regeneron and Syneos.

DL: Nothing to disclose.

LJ: Nothing to disclose.

LBB: Reports grants or contracts from NIH/NIAID; book royalties from Elsevier; consulting fees from Sanofi, Regeneron, Genentech, GSK, DBV technologies, Teva, Medscape, Kinaset, OM Pharma, AstraZeneca, Recludix; personal fees from Sanofi and Regeneron; participation in DSMB or Advisory Board for DBV Technologies, AstraZeneca, Vertex, and Aravax; leadership or fiduciary role in other board, society, committee or advocacy group for the AAAAI and the American Board of Allergy and Immunology (ABAI); receipt of medical writing services from Sanofi/Regeneron.

JRS: Reports personal fees as Uptodate contributor; support for attending meetings and/or travel from the AAAAI; leadership or fiduciary role for the ABAI.

ST: Reports grants or contracts from NIH/NIAID, NIH/NHLBI, NIH/NICHD and Novartis; royalties or licenses from UptoDate Inc.;

WJM: Reports grants or contracts from NIH/NHLBI, Boston Children’s Hospital/Harvard, and the Cystic Fibrosis Foundation; consulting feeds from the Cystic Fibrosis Foundation; personal fees from the American College of Chest Physicians; support for meeting attendance and/or travel from the Cystic Fibrosis Foundation; chair of the DSMB for the Cystic Fibrosis Foundation; DSMB or advisory board participation for NIH/NHLBI.

FM: Reports grants or contracts from NIH/NHLBI, NIH/NIAID, NIH/NICHHD, NIH/Office of the Director, OM Pharma, and American Lung Association; consulting fees from OM Pharma

References

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    1. Organization WH. Coronavirus disease (COVID-19) pandemic. Volume 2025, 2025.
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