Does having asthma make a preschooler more likely to get a respiratory tract infection?
Asthma is a chronic condition that causes inflammation and narrowing of the airways. In preschoolers, asthma has been linked to a higher chance of getting respiratory tract infections (RTIs), including both upper (like colds) and lower (like pneumonia) infections. Research shows that children with asthma are more vulnerable to repeated RTIs, and the relationship may go both ways: asthma increases infection risk, and early severe infections may also raise the risk of developing asthma later.
What the research says
A large meta-analysis of 12 studies involving over 170,000 preschool children found that asthma is a significant risk factor for recurrent respiratory tract infections (RRTI), with an odds ratio of 3.26 (95% CI: 1.85-5.7) 4. This means children with asthma have about three times the odds of experiencing repeated RTIs compared to children without asthma. The same study also identified passive smoking and frequent snack intake as additional risk factors 4.
Other research supports this link. One study on infants hospitalized with lower respiratory tract infections found that those with more severe infections (like pneumonia and bronchiolitis) were more likely to develop asthma later 5. This suggests a two-way relationship: asthma can make infections more likely, and early infections can contribute to asthma development.
Maternal asthma also plays a role. A study found that infants whose mothers had atopic asthma were more than twice as likely to have rhinovirus (a common cold virus) versus RSV infection, and those rhinovirus infections were more severe 6. This indicates that a family history of asthma can influence both the type and severity of respiratory infections in young children.
Additionally, research on the upper airway microbiome shows that children who had lower respiratory tract infections early in life had different nasal bacteria (lower diversity, more Moraxella) and were more likely to wheeze 7. While this study did not directly test asthma as a risk factor, it highlights how infection and airway health are closely connected in early childhood.
What to ask your doctor
- Given my child's asthma, what can we do to reduce the risk of respiratory infections?
- Are there any specific vaccines (like flu or RSV) that are recommended for my child?
- How can we tell if a cough or cold is just a mild infection versus a sign of an asthma flare-up?
- Should we consider any preventive medications or treatments to lower infection risk?
- What symptoms should prompt us to seek medical care right away?
This question is drawn from common patient questions about Pulmonology & Critical Care and answered using cited medical research. We do not provide individualized advice.