J Allergy Clin Immunol

COVID-19 infection linked to increased risk of airway inflammation; vaccination protective

August 27, 2025

Study details: A retrospective matched cohort study analyzed electronic health records from over 118 million U.S. patients and compared three groups: those with COVID-19 infection (n=973,794), those vaccinated against COVID-19 (n=691,270), and unexposed controls (n=4,388,409). Propensity-score matching balanced demographic and clinical covariates. Incident cases of asthma, allergic rhinitis, chronic rhinosinusitis, atopic dermatitis, and eosinophilic esophagitis were tracked over a three-month follow-up.

Results: COVID-19 infection was associated with a significantly increased risk of new-onset asthma (hazard ratio [HR], 1.66; 95% confidence interval [CI], 1.59–1.73), allergic rhinitis (HR, 1.27; 95% CI, 1.21–1.33), and chronic rhinosinusitis (HR, 1.74; 95% CI, 1.67–1.82). No significant changes were observed for atopic dermatitis or eosinophilic esophagitis. In contrast, vaccination was associated with reduced risks of asthma (HR, 0.68; 95% CI, 0.64–0.72) and chronic rhinosinusitis (HR, 0.80; 95% CI, 0.75–0.85). Direct comparison revealed a two- to threefold greater risk of respiratory type-2 inflammatory diseases following infection vs. vaccination.

Clinical impact: COVID-19 may trigger type-2 airway inflammation, elevating the risk of respiratory conditions. Vaccination is associated with a reduced likelihood of post-infectious respiratory complications, underscoring its role in long-term disease prevention.

Source:

Olbrich H, et al. (2025, August 12). J Allergy Clin Immunol. COVID-19 infection raises respiratory type-2 inflammatory disease risk, whereas vaccination is protective. https://pubmed.ncbi.nlm.nih.gov/40812431/