Childhood asthma diagnoses declined during the COVID-19 pandemic in the United States

Daniel B. Horton, Amanda L. Neikirk, Yiling Yang, Cecilia Huang, Reynold A. Panettieri, Stephen Crystal, Brian L. Strom, Lauren E. Parlett

Research output: Contribution to journalLetterpeer-review

3 Scopus citations


Background: Prior studies have documented declines in pediatric asthma exacerbations and asthma-related health care utilization during the COVID-19 pandemic, but less is known about the incidence of asthma during the pandemic. Methods: We conducted a retrospective cohort study of children under age 18 without a prior diagnosis of asthma within a large US commercial claims database. Incident asthma was defined using a combination of diagnosis codes, location of services, and medication dispensing. Crude quarterly rates of asthma diagnosis per 1000 children were calculated, and the incidence rate ratio and 95% confidence interval were estimated for newly diagnosed asthma during versus before the pandemic using negative binomial regression, adjusted for age, sex, region, and season. Results: Compared with 3 years prior to the pandemic, crude incident diagnosis rates of asthma decreased by 52% across the first four quarters of the US pandemic. The covariate-adjusted pandemic-associated incidence rate ratio was 0.47 (95% confidence interval 0.43, 0.51). Conclusions: New diagnoses of childhood asthma in the US declined by half during the first year of the pandemic. These findings raise important questions whether pandemic-related changes in infectious or other triggers truly altered the incidence of childhood asthma beyond the well-described disruptions in healthcare access.

Original languageEnglish (US)
Article number72
JournalRespiratory Research
Issue number1
StatePublished - Dec 2023

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine


  • Adolescent
  • Asthma/epidemiology
  • Child
  • Database
  • Pandemics


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