Asthmatic children who tested positive for COVID-19 experienced changes in lung function and persistent symptoms following SARS-CoV-2 infection, even for several months after diagnosis, and with the same features as in an acute phase. This study aimed to analyze a pediatric age group (between 0 and 17 years old) diagnosed with asthma, and SARS-CoV-2 infection attending regular monitoring visits in a Pediatric Department of a Regional Tertiary Hospital (Filantropia Clinical Municipal Hospital Craiova, Romania) during the COVID-19 pandemic and post-pandemic time interval (i.e., March 2020–July 2024), and identify how the infection influenced their long-term symptoms and treatment. Materials and Methods. The following variables were recorded: demographic data (gender, age group, residence), data related to allergies (allergic rhinitis, atopic dermatitis, and food allergies), the presence of exacerbations, the fraction of exhaled nitric oxide, the ventilatory function, the asthma phenotype (allergic or non-allergic), as well as the GINA assessment of asthma control at clinical visits were analyzed. SARS-CoV-2 infections were evaluated in terms of year of infection, symptoms, cough presence and persistence, and modifications of the asthma treatment during and after COVID-19 disease. The data were statistically analyzed with SPSS, using the Mann–Whitney U, Kruskal–Wallis H, and Chi-Square tests. Results. A lower incidence of COVID-19 cases was recorded in the first pandemic of asthmatic patients (2020 and 2021), but an increase in the rate of cases was observed at the beginning of the second pandemic, in 2022. The nitric oxide values in asthmatic children who were infected with SARS-CoV-2 were statistically significantly increased (p < 0.0005), especially for children with persistent cough for more than 4 weeks. A significant increase in the number of exacerbations was also observed in patients who tested positive for SARS-CoV-2 infection (p < 0.0005). Ventilatory function values were statistically significantly different in asthmatic children with and without SARS-CoV-2 infection (p < 0.05). Conclusions. The persistence of cough after the acute phase of SARS-CoV-2 infection as well as the changes in ventilatory tests emphasize the need of periodic medical check-ups, as well as the implementation of a therapeutic regimen appropriate for each pediatric patient.

Background/Objectives: Asthma outcomes in children and adolescents largely depend on parental adherence to prescribed treatment plans. This study investigates how the COVID-19 pandemic influenced parental decision-making in managing their children’s asthma, regardless of whether the children were infected with SARS-CoV-2. Material and method: In this research, 146 children with asthma were analyzed based on the following data: demographic parameters (gender, age group, and residence), before and after measurements of FeNO and pulmonary function test parameters were performed to assess the evolution of asthma for infected and non-infected children, exacerbations, parents’ compliance with the treatment, changes in treatment steps performed by physicians, and the GINA asthma control levels. Results: The effect of parent self-management of doses was evident in the variation of FeNO and pulmonary function test parameters before and after COVID-19 disease, including children with asthma who did not contract the virus, in the decrease in well-controlled asthma cases, as well as in the number of exacerbations per year. A step-down in treatment doses was statistically associated with increased FeNO values (p < 0.0005), and decreased FEV1 values (p = 0.025). Higher values of FeNO were statistically significantly associated with a higher number of exacerbations per year (p < 0.0005). There was a statistically significant moderately strong association between the treatment steps evolution (decided by the attending physician) and parents’ self-management of doses in the attempt to assess the control of the disease of children with asthma (p = 0.019). Also, 80.95% of children for whom the parents performed a step-down in dose no longer presented well-controlled asthma, leading to a statistically significant association relative to the level of asthma control and doses adjustments (p < 0.0005). Conclusions: During epidemiological circumstances, a strong collaboration between the parents/caregivers/pediatric patients with asthma and attending physicians is essential to correctly assess the symptoms and to comply the asthma treatment with ICS and a bronchodilator in order to control the disease.

Background/Objectives: Vitamin D is known to decrease the risk of contracting respiratory infections and developing exacerbations for children with asthma. This research evaluates the alterations in serum vitamin D concentrations and examines lung function in children with asthma, as indicated by clinical symptoms and paraclinical results, after experiencing SARS-CoV-2 infection or other acute respiratory infections. Material and Method: This retrospective study included 145 children with asthma. For each patient, the following variables were acquired: demographic data, serum vitamin D levels, GINA asthma control levels, the fraction of exhaled nitric oxide (FeNO), pulmonary function tests parameters, data related to allergies, and the presence of exacerbations. Children were divided into two groups, according to the presence or absence of SARS-CoV-2 infection or other acute respiratory infections. Variables were statistically processed in SPSS. Results: In total, 93 children with asthma with SARS-CoV-2 infection or other acute respiratory infections and 52 children with asthma without SARS-CoV-2 infection or other acute respiratory infections were included in the study. Median serum vitamin D values were statistically significantly lower in children with a variable airflow limitation, compared to children with normal values (p = 0.004), as well as for children with partially controlled asthma, relative to children with well controlled asthma (p < 0.0005). Similarly, children with acute respiratory infections/COVID-19 disease had lower median values of serum vitamin D, compared to children without acute respiratory infections/COVID-19 disease (p < 0.0005). A decrease in serum vitamin D value was statistically significantly associated with an increase in FeNO value for children with asthma with COVID-19 disease (p = 0.027), as well as for the entire study group (p < 0.0005). Conclusions: Children with asthma who had acute respiratory infections, including COVID-19 disease, showed considerably reduced serum vitamin D levels and were linked to more significant airflow limitation, reduced asthma control and elevated airway inflammation, suggesting its potential role in influencing asthma severity and infection response.