{"doi":"10.1111/pai.13696","title":"Asthma as a risk factor for hospitalization in children with COVID‐19: A nested case‐control study","abstract":"BACKGROUND: Most pediatric studies of asthma and COVID-19 to date have been ecological, which offer limited insight. We evaluated the association between asthma and COVID-19 at an individual level. METHODS: Using data from prospective clinical registries, we conducted a nested case-control study comparing three groups: children with COVID-19 and underlying asthma (\"A+C\" cases); children with COVID-19 without underlying disease (\"C+\" controls); and children with asthma without COVID-19 (\"A+\" controls). RESULTS: The cohort included 142 A+C cases, 1110 C+ controls, and 140 A+ controls. A+C cases were more likely than C+ controls to present with dyspnea and wheezing, to receive pharmacologic treatment including systemic steroids (all p < .01), and to be hospitalized (4.9% vs. 1.7%, p = .01). In the adjusted analysis, A+C cases were nearly 4 times more likely to be hospitalized than C+ controls (adjusted OR = 3.95 [95%CI = 1.4-10.9]); however, length of stay and respiratory support level did not differ between groups. Among A+C cases, 8.5% presented with an asthma exacerbation and another 6.3% developed acute exacerbation symptoms shortly after testing positive for SARS-CoV-2. Compared to historic A+ controls, A+C cases had less severe asthma, were less likely to be on controller medications, and had better asthma symptom control (all p < .01). CONCLUSIONS: In our cohort, asthma was a risk factor for hospitalization in children with COVID-19, but not for worse COVID-19 outcomes. SARS-CoV-2 does not seem to be a strong trigger for pediatric asthma exacerbations. Asthma severity was not associated with higher risk of COVID-19.","journal":"Pediatric Allergy and Immunology","year":2021,"id":157311,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":51,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9214,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":521847,"name":"Megan Culler Freeman","orcid":"0000-0003-3389-6731","position":1,"is_corresponding":false},{"id":559663,"name":"Leigh Anne DiCicco","orcid":null,"position":2,"is_corresponding":false},{"id":559664,"name":"Sherry Rauenswinter","orcid":null,"position":3,"is_corresponding":false},{"id":559665,"name":"Joseph R Squire","orcid":null,"position":4,"is_corresponding":false},{"id":558541,"name":"Zachary Aldewereld","orcid":"0000-0003-4367-9036","position":5,"is_corresponding":false},{"id":558543,"name":"Jennifer Iagnemma","orcid":"0000-0003-1705-7313","position":6,"is_corresponding":false},{"id":558544,"name":"Brian T. Campfield","orcid":"0000-0002-5380-9837","position":7,"is_corresponding":false},{"id":558545,"name":"David Wolfson","orcid":"0000-0002-3185-4610","position":8,"is_corresponding":false},{"id":456459,"name":"Traci M. Kazmerski","orcid":"0000-0002-3916-8260","position":9,"is_corresponding":false},{"id":277431,"name":"Erick Forno","orcid":"0000-0001-6497-9885","position":10,"is_corresponding":false},{"id":558540,"name":"K.M. Gaietto","orcid":"0000-0002-4618-2984","position":0,"is_corresponding":true}],"reference_count":39,"raw_metadata":null,"created_at":"2026-07-18T23:44:17.471040Z","pmid":"34775650","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}