Coronavirus Disease 2019 and Pediatric Asthma: Friend or foe?

Elissa M. Abrams


Curr Opin Allergy Clin Immunol. 2022;22(2):95-100. 

In This Article

Unintended Consequences and the Role of Social Determinants of Health

Clear evidence exists for the negative impact that adverse determinants of health can have on COVID-19 outcomes among children and their families.[50,51] Children and their families experiencing homelessness are at higher risk of COVID-19, and lack access to care.[52] Poverty, which has increased exponentially in the United States and elsewhere during the pandemic, has been strongly associated with COVID-19 outcomes, with a US study noting a close to four-fold higher death rate among counties with more, versus less, poverty.[53] There are racial and ethnic discrepancies in COVID-19 infection, with a two-fold higher rate of cases among Hispanic persons, a three-fold higher rate of hospitalization and a two-fold higher rate of death.[54] For Black or African American non-Hispanic persons, there is a three-fold higher risk of hospitalization and a two-fold higher risk of death.[54] While necessary, sequelae of public health policies such as school closures disproportionately impact those facing adverse determinants.[55] It has been stated that 'no credible scientist, learning expert, teacher or parent believes that children aged 5 to 10 years can meaningfully engage in online learning without considerable parental involvement, which many families with low incomes are unable to provide because parents must work outside the home'.[56] On the contrary, the impact of adverse social determinants and COVID-19 outcomes are compounded in children with asthma,[50] as food insecurity, poverty, race/ethnicity and many other determinants can have persistent effects on childhood asthma outcomes as well.[50,57]