Incidence Of Asthma Research Articles

Childhood Asthma Incidence, Early and Persistent Wheeze, and Neighborhood Socioeconomic Factors in the ECHO/CREW Consortium.

Childhood Asthma Incidence, Early and Persistent Wheeze, and Neighborhood Socioeconomic Factors in the ECHO/CREW Consortium.

Increased blood eosinophils and airflow obstruction as new-onset asthma predictors in the elderly: The Nagahama study

BackgroundAsthma in the elderly needs more attention in an aging society. However, it is likely to remain underdiagnosed and undertreated. This study aimed to clarify clinical characteristics of new-onset asthma in the elderly, describing the prevalence, predictive factors, and comorbidities after asthma diagnosis of new-onset asthma in the elderly in the general population. MethodsThis community-based prospective cohort study enrolled 9804 generally healthy participants (30–74 years old) in Nagahama City, and conducted a follow-up assessment after 5 years. Elderly participants were those aged ≥65 years at baseline. Patients with new-onset asthma were defined as participants without asthma at baseline assessment and with asthma at the follow-up assessment. ResultsAmong the 7948 participants analyzed in this study, 28 (1.4%) elderly and 130 (2.2%) non-elderly had new-onset asthma. Multiple logistic regression analysis revealed low forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) and high blood eosinophil counts at baseline as predicting factors for new-onset asthma in the elderly. Additionally, subsequent incidence of new-onset asthma was higher in elderly participants with both predictors (high blood eosinophil counts and low FEV1/FVC at baseline) than those with none or one of the predictors before asthma diagnosis. Lastly, elderly patients with new-onset asthma had more frequent comorbidity of moderate to severe sleep disordered breathing than those non-elderly. ConclusionsEosinophilic inflammation and airflow obstruction may predict subsequent new-onset asthma after the age of 65 years. Revealing the characteristics of new-onset asthma in the elderly can aid in the prevention of underdiagnosed asthma.

Socio-demographic and environmental factors impacting asthma exacerbations in children in Taif city, Saudi Arabia

Background Asthma is a chronic inflammatory disorder of the airways resulting in episodic reversible obstruction of the airways leading to breathlessness, tightness, chest, cough and wheezing. Children with bronchial Asthma lifestyles are disrupted to various extents based on bronchial Asthma severity. School-aged children with asthma experience more hospitalizations, more school absenteeism, academic underachievement, decreased overall activity, and disruption of family functioning compared to healthy classmates. The incidence of asthma has increased considerably in the last few years. Aims: The aim of this study was to assess the role of associated sociodemographic and environmental risk factors in the severity of school-aged children's asthma in Taif, Saudi Arabia, for providing care to a child. Methodology: In a case-control cross-sectional study, the incidence and severity of asthma symptoms were carried out through well-designed questionnaires distributed during the period from April to May 2023 according to 11 standardized methods of population-based survey protocols. Results: The incidence frequency of bronchial asthma was (51.09%). The highest incidence rate of asthma was reported among the age group of 8-10 having a percentage of 36% followed by the age group of 10-12 (33.5%) and the age group 6-8 (30.5%) having the lowest incidence rate of asthma. Allergens and weather conditions were the most prevalent factors triggering severe and exacerbating childhood bronchial Asthma attacks. Conclusion Pediatric Asthma is one of the most common chronic pediatric chest inflammatory disorders. Consistently children with Asthma have lower life quality. Children with asthma can live safely after narrowing these factors. Physicians must promote to patients the necessary knowledge and care for effective self-management of the disease process and improve life quality. These results offer sufficient information regarding the incidence rate and severity of asthma symptoms, asthma management, and related risk factors for Saudi Arabian health authorities to scale up surveillance initiatives, control, and high-impact treatments.

Life’s Essential 8, genetic predisposition, and risk of incident adult-onset asthma: a prospective cohort study

BackgroundAdult-onset asthma (AOA) and cardiovascular diseases shared common risk factors and similar pathophysiologic resemblances. The American Heart Association (AHA) unveiled the life’s essential 8 (LE8) to promote cardiovascular health (CVH). This study aimed to assess the overall impact of LE8 implementation on AOA prevention. MethodsAccording to the guideline of AHA’s Construct of CVH in 2022, LE8 score was calculated from 8 health status concerning diet, physical activity, nicotine exposure, sleep health, body mass index, blood lipids, blood glucose, and blood pressure. Cox proportional-hazards models were used to estimate effect sizes of associations between CVH, asthma genetic risk, and risk of incident AOA in participants selected from the UK Biobank study. ResultsA total of 6180 incident AOA cases occurred in 249,713 participants during an average of 11.60 y’ follow-up. A higher LE8 score was associated with a lower risk of incident AOA with a significant linear trend (P < 0.0001). Every standard deviation increment of LE8 was associated with a 17% (HR: 0.83; 95% CI: 0.81, 0.85) lower risk of incident AOA. Compared with participants with low-CVH score, participants with moderate (HR: 0.72; 95% CI: 0.67, 0.78) and high CVH scores (HR: 0.52; 95% CI: 0.47, 0.58) were associated with a lower risk of incident AOA (P-trend < 0.0001). No significant multiplicative or additive interaction was found between LE8 score and genetic risks. Stratified analysis showed a consistent association between CVH and risk of incident AOA across different asthma polygenic risk score (PRS) levels. Compared with participants with high PRS and low CVH, participants with low PRS and high CVH experienced the lowest risk (HR: 0.28; 95% CI: 0.23, 0.34) of incident AOA. ConclusionsOur findings suggest that maintaining optimal CVH should be recommended as a preventive strategy for AOA, regardless of their asthma genetic risks.

Association of cesarean section with asthma in children/adolescents: a systematic review and meta-analysis based on cohort studies

BackgroundWhether cesarean section (CS) is a risk factor for asthma in offspring is controversial. The purpose of this study was to investigate the association between CS and asthma in children/adolescents.MethodsPubmed, Embase, Web of Science, and Cochrane Library electronic databases were searched for cohort studies on the relationship between mode of delivery and asthma in children/adolescents up to February 2023. Birth via CS was considered an exposure factor. Asthma incidence was taken as a result.ResultsThirty-five cohort studies (thirteen prospective and twenty-two retrospective cohort studies) were included. The results showed that the incidence of asthma was higher in CS offspring (odds ratio (OR) = 1.18, P < 0.001) than in the vaginal delivery (VD) group. Partial subgroup analyses showed a higher incidence of asthma in female offspring born via CS (OR = 1.26, P < 0.001) compared with the VD group, while there was no difference in males (OR = 1.07, P = 0.325). Asthma incidence was higher in CS offspring than in the VD group in Europe (OR = 1.20, P < 0.001), North America (OR = 1.15, P < 0.001), and Oceania (OR = 1.06, P = 0.008). This trend was not found in the Asian population (OR = 1.17, P = 0.102). The incidence of atopic asthma was higher in offspring born via CS (OR = 1.14, P < 0.001) compared to the VD group. The CS group had a higher incidence of persistent asthma, but the difference did not reach statistical significance (OR = 1.15, P = 0.063).ConclusionIn this meta-analysis, CS may be a risk factor for asthma in offspring children/adolescents compared with VD. The relationship between CS and asthma was influenced by sex and region.

Incident Asthma, Asthma Exacerbations, and Asthma-Related Hospitalizations in Patients With Atopic Dermatitis

Atopic dermatitis (AD) is thought to induce asthma via the "atopic march," but the effects of AD on incident asthma and asthma severity have not been fully characterized. To determine risk of asthma, asthma exacerbations, and asthma-related hospitalizations among patientsfwith AD. A cohort study was conducted using electronic health records data from UK general practices from 1994 to 2015. Children (<18 years old) and adults (≥18 years) with AD were matched on age, practice, and index date to patients without AD. AD severity was categorized using treatments and dermatologist referrals. Outcomes were incident asthma among all patients and asthma exacerbation or hospitalization among patients with asthma. On comparing 409,341 children with AD (93.2% mild, 5.5% moderate, 1.3% severe) with 1,809,029 unaffected children, those with AD were found to be associated with a 2-fold greater risk of asthma compared with those without AD (hazard ratio, 1.96; 95% CI, 1.93-1.98). On comparing 625,083 adults with AD (65.7% mild, 31.4% moderate, and 2.9% severe) with 2,678,888 unaffected adults, AD was found to be associated with a 38% higher risk of asthma (hazard ratio, 1.38; 95% CI, 1.36-1.40). Asthmatic patients with AD also had a 21% to 63% greater risk of asthma exacerbations and a 20% to 64% greater risk of asthma-related hospitalizations compared with asthmatic patients without AD. Risk of asthma, asthma exacerbation, or asthma-related hospitalization increased with AD severity in a dose-dependent manner in both the pediatric and adult cohorts. AD, especially in children and when more severe, is associated with greater risk of asthma as well as greater risk of asthma exacerbations and hospitalizations among asthmatic patients.

Chemokine CCL19 promotes type 2 T-cell differentiation and allergic airway inflammation

Allergic asthma is driven largely by allergen-specific TH2 cells, which develop in regional lymph nodes on the interaction of naive CD4+ T cells with allergen-bearing dendritic cells that migrate from the lung. This migration event is dependent on CCR7 and its chemokine ligand, CCL21. However, is has been unclear whether the other CCR7 ligand, CCL19, has a role in allergic airway disease. This study sought to define the role of CCL19 in TH2 differentiation and allergic airway disease. Ccl19-deficient mice were studied in an animal model of allergic asthma. Dendritic cells or fibroblastic reticular cells from wild-type and Ccl19-deficient mice were cultured with naive CD4+ T cells, and cytokine production was measured by ELISA. Recombinant CCL19 was added to CD4+ T-cell cultures, and gene expression was assessed by RNA-sequencing and quantitative PCR. Transcription factor activation was assessed by flow cytometry. Lungs of Ccl19-deficient mice had less allergic airway inflammation, reduced airway hyperresponsiveness, and less IL-4 and IL-13 production compared with lungs of Ccl19-sufficient animals. Naive CD4+ T cells cocultured with Ccl19-deficient dendritic cells or fibroblastic reticular cells produced lower amounts of type 2 cytokines than did T cells cocultured with their wild-type counterparts. Recombinant CCL19 increased phosphorylation of STAT5 and induced expression of genes associated with TH2 cell and IL-2 signaling pathways. These results reveal a novel, TH2 cell-inducing function of CCL19 in allergic airway disease and suggest that strategies to block this pathway might help to reduce the incidence or severity of allergic asthma.

Asthma incidence can be influenced by climate change in Italy: findings from the GEIRD study—a climatological and epidemiological assessment

An association between climatic conditions and asthma incidence has been widely assumed. However, it is unclear whether climatic variations have a fingerprint on asthma dynamics over long time intervals. The aim of this study is to detect a possible correlation of the Summer North Atlantic Oscillation (S-NAO) index and the self-calibrated palmer drought severity index (scPDSI) with asthma incidence over the period from 1957 to 2006 in Italy. To this aim, an analysis of non-stationary and non-linear signals was performed on the time series of the Italian databases on respiratory health (ISAYA and GEIRD) including 36,255 individuals overall, S-NAO, and scPDSI indices to search for characteristic periodicities. The ISAYA (Italian Study on Asthma in Young Adults) and GEIRD (Gene Environment Interactions in Respiratory Diseases) studies collected information on respiratory health in general population samples, born between 1925 and 1989 and aged 20–84 years at the time of the interview, from 13 Italian centres. We found that annual asthma total incidence shared the same periodicity throughout the 1957–2006 time interval. Asthma incidence turned out to be correlated with the dynamics of the scPDSI, modulated by the S-NAO, sharing the same averaged 6 year-periodicity. Since climate patterns appear to influence asthma incidence, future studies aimed at elucidating the complex relationships between climate and asthma incidence are warranted.

Risk of Incident Asthma Among Young Asian American, Native Hawaiian, and Pacific Islander Children from Age 3 to 7 Years in a Northern California Healthcare System

Incident childhood asthma risk has not been examined among diverse Asian American, Native Hawaiian, and Pacific Islander subgroups. In a large California healthcare system, incident asthma was higher among young Filipino/a, Native Hawaiian/Pacific Islander, and South Asian children compared with non-Hispanic White children, whereas Chinese and Japanese children were similar.

Mitigation potential of local traffic interventions on paediatric asthma incidence in EU cities

Abstract Issue/Problem Motorised road traffic is a major contributor to Nitrogen Dioxide (NO2) emissions, contributing to the development and worsening of asthma. With a substantial and escalating prevalence of asthma in urban areas worldwide, this is an issue of public health significance. Description of the problem Deploying methods such as Random Forests and Boosted Regression Trees, this study aims to determine the potential reduction in paediatric asthma incidence in European cities that could be achieved through policy interventions targeting local traffic reductions, such as car-free days. Results In trafficked areas in European cities such as Brussels and Paris, up to 40% of asthma incidence can be attributed to NO2 exposure. Preliminary results show a potential reduction of 29% [95% CI: 20-34%], 21% [95% CI: 13-25%], and 12% [95% CI: 7-15 %] in paediatric asthma incidence in trafficked areas, central urban areas, and residential areas in Brussels, respectively. In Trafficked and Urban Background Areas in Paris, we found a potential reduction of 17% [95% CI: 11 -19%] and 13% [95% CI: 8-16%] in paediatric asthma incidence respectively. Trends and findings are consistent with several methodologies applied. Lessons Using real-world interventions such as car-free days is an innovative way to assess the mitigation potential of diseases associated with traffic. Our study highlights the public health significance of local traffic reduction policies in addressing asthma incidence in urban areas. The recommended public health actions include implementing policy interventions to reduce traffic levels and emissions in urban areas. These findings can be useful for other countries/settings facing similar issues with traffic-related air pollution and asthma incidence. The policy intervention can also positively impact other traffic-related health effects such as physical activity, noise, and availability of green spaces. Key messages • Local traffic reduction policies can significantly reduce (paediatric) asthma incidence in urban areas in large European Cities. • Reducing traffic levels reduces traffic-related air pollution and improves public health via pathways such as promoting physical activity, reducing noise, and increasing green space availability.

Obesity-Associated Non-T2 Mechanisms in Obese Asthmatic Individuals.

Obesity and asthma are two common health issues that have shown increased prevalence in recent years and have become a significant socioeconomic burden worldwide. Obesity increases asthma incidence and severity. Obese asthmatic individuals often experience increased exacerbation rates, enhanced airway remodeling, and reduced response to standard corticosteroid therapy. Recent studies indicate that obesity-associated non-T2 factors such as mechanical stress, hyperinsulinemia, systemic inflammation, adipose tissue mediators, metabolic dysregulation, microbiome dysbiosis, and high-fat-diet are responsible for increased asthma symptoms and reduced therapeutic response in obese asthmatic individuals. This manuscript reviews the recent findings highlighting the role of obesity-associated factors that contribute to airway hyper-reactivity, airway inflammation and remodeling, and immune cell dysfunction, consequently contributing to worsening asthma symptoms. Furthermore, the review also discusses the possible future therapies that might play a role in reducing asthma symptoms by diminishing the impact of obesity-associated non-T2 factors.

Maternal gestational diabetes mellitus and the childhood asthma in offspring: a meta-analysis

BackgroundMaternal diabetes might be related to a high risk of allergic disease in offspring. However, it remains unknown if maternal gestational diabetes mellitus (GDM) is also associated with a high incidence of childhood asthma in offspring. A systematic review and meta-analysis was performed to investigate the above association.MethodsRelevant observational studies were obtained by search of electronic databases including Medline, Embase, Cochrane Library, and Web of Science. A randomized-effects model was selected to pool the data by incorporating the influence of potential heterogeneity. The Newcastle-Ottawa Scale was used for study quality evaluation. Subgroup analyses were performed to evaluate the potential influences of study characteristics on the outcome.ResultsTen datasets from seven moderate to high quality cohort studies, involving 523,047 mother-child pairs were included in the meta-analysis. Overall, maternal GDM was associated with a higher risk of childhood asthma in offspring (risk ratio [RR]: 1.22, 95% confidence interval [CI]: 1.07 to 1.39, p = 0.003; I2 = 30%). Subgroup analyses showed that the association was not significantly affected by study design, validation methods for GDM, or diagnostic strategy for asthma (p for subgroup analyses all > 0.05). The association between maternal GDM and asthma in offspring was more remarkable after adjusting maternal body mass index in early pregnancy (RR: 1.50 versus 1.06, p < 0.001), but significantly weakened after adjusting hypertensive disorders during pregnancy (RR: 1.08 versus 1.50, p = 0.001).ConclusionsMaternal GDM may be associated with an increased incidence of childhood asthma in offspring.

Recent research on the relationship between pulmonary microbiome and asthma endotypes in children

Bronchial asthma is not considered a singular disease, but rather a collection of syndromes with multiple phenotypes and mechanisms that involve various signaling pathways. It typically emerges during the preschool years, and its etiology is intricate and diverse. In recent years, the advancement of high-throughput sequencing technology has revealed that early alterations in lung microbiota may be associated with asthma incidence and progression. Moreover, significant variations in lung microbiota have been observed among different airway inflammation profiles, known as asthma endotypes. Hence, a comprehensive understanding of the characteristics of lung microbiota in children with asthma can aid in managing disease progression and improving long-term prognosis. Additionally, such insights may spark novel approaches to diagnosing and treating childhood asthma.

Environmental Exposure and Pediatric Asthma Prevalence in Saudi Arabia: A Cross-Sectional Study.

Asthma is a chronic respiratory disease characterized by recurrent episodes of wheezing and shortness of breath. Currently, there is no cure for asthma. However, through accurate diagnosis, appropriate therapy, and effective management strategies, individuals with asthma can achieve a better quality of life. This study focused on determining the prevalence and environmental risk factors of pediatric asthma among children in Saudi Arabia. This cross-sectional study was undertaken from January 2023 to August 2023, encompassing five key regions in Saudi Arabia: Central, Eastern, Northern, Southern, and Western. A structured online questionnaire was disseminated to parents/guardians of children aged 2-18 with a confirmed diagnosis of asthma. The objective was to garner insights regarding pediatric asthma prevalence and associated risk factors within these regions. The questionnaire was designed with considerations for sociodemographic factors, environmental exposures, and known asthma triggers. From the survey's distribution, a total of 1666 responses were accumulated and processed for further analysis. The survey saw the participation of 1666 respondents. The age bracket of 8-13 years had the highest representation, accounting for 52.5% of the total participants. From the total cohort, 26.9% had been diagnosed with pediatric asthma. It was also observed that 56.7% of the participants resided in areas marked by high traffic or were proximate to busy roads. Additionally, 30.7% of the respondents pinpointed specific times in the year when asthma symptoms intensified. When dissecting the data, it was discerned that there were statistically significant associations between the prevalence of pediatric asthma, gender, and the regions of Saudi Arabia with reference to air pollution exposure. Notably, gender had an odds ratio of 1.12, while the regional distribution held an odds ratio of 1. Our study vividly highlights the intricate landscape of pediatric asthma across Saudi Arabia, indicating its prevalence and drawing attention to associated risk factors. Noteworthy observations include the pronounced impact of gender and regional variances, particularly concerning air pollution exposure, on asthma incidence. The insights gleaned from this research are invaluable in steering the formulation and implementation of strategic interventions geared towards bolstering children's health and enhancing their life quality in regions bearing the brunt of pediatric asthma.

Prenatal exposure to poly- and perfluoroalkyl substances and the incidence of asthma in early childhood

Exposure to polyand perfluoroalkyl substances (PFAS) in early life may increase the risk of childhood asthma, but evidence has been inconsistent. We estimated associations between maternal serum concentrations of PFAS during pregnancy and clinician-diagnosed asthma incidence in offspring through age eight. We included 597 mother-child pairs with PFAS quantified in mid-pregnancy serum and childhood medical records reviewed for asthma diagnoses. We used separate Cox proportional hazards models to assess the relationship between log-transformed concentrations of five PFAS and the incidence of asthma. We estimated associations between the PFAS mixture and clinician-diagnosed asthma incidence using quantile-based g-computation. PFAS concentrations were similar to those among females in the US general population. Seventeen percent of children (N = 104) were diagnosed with asthma during follow-up. Median (interquartile range) duration of follow-up was 4.7 (4.0, 6.2) years, and median age at asthma diagnosis was 1.7 (0.9, 2.8) years. All adjusted hazard ratios (HRs) were elevated, but all 95% confidence intervals (CI) included the null. The HR (95% CI) of asthma for a one-quartile increase in the PFAS mixture was 1.17 (0.86, 1.61). In this cohort of children followed to eight years of age, prenatal PFAS concentrations were not significantly associated with incidence of clinician-diagnosed asthma.

Degranulation of human mast cells: modulation by P2 receptors' agonists.

Since the late 1970s, there has been an alarming increase in the incidence of asthma and its morbidity and mortality. Acute obstruction and inflammation of allergic asthmatic airways are frequently caused by inhalation of exogenous substances such as allergens cross-linking IgE receptors expressed on the surface of the human lung mast cells (HLMC). The degree of constriction of human airways produced by identical amounts of inhaled allergens may vary from day to day and even hour to hour. Endogenous factors in the human mast cell (HMC)'s microenvironment during allergen exposure may markedly modulate the degranulation response. An increase in allergic responsiveness may significantly enhance bronchoconstriction and breathlessness. This review focuses on the role that the ubiquitous endogenous purine nucleotide, extracellular adenosine 5'-triphosphate (ATP), which is a component of the damage-associated molecular patterns, plays in mast cells' physiology. ATP activates P2 purinergic cell-surface receptors (P2R) to trigger signaling cascades resulting in heightened inflammatory responses. ATP is the most potent enhancer of IgE-mediated HLMC degranulation described to date. Current knowledge of ATP as it relates to targeted receptor(s) on HMC along with most recent studies exploring HMC post-receptor activation pathways are discussed. In addition, the reviewed studies may explain why brief, minimal exposures to allergens (e.g., dust, cat, mouse, and grass) can unpredictably lead to intense clinical reactions. Furthermore, potential therapeutic approaches targeting ATP-related enhancement of allergic reactions are presented.

The impact of urban air pollution on human health

Atmospheric air can be polluted as a result of the ingress of various chemicals into it, which have a harmful effect on human health, causing an exacerbation of cardiovascular, airborne diseases, diseases of the gastrointestinal tract and the endocrine system, and exceeding the norms of dust content in the air leads to an increase in incidence of allergies and bronchial asthma. The relevance of the subject under study lies in the investigation of the sources of air pollution, as they lead to an increase in the degree of morbidity and mortality among the population. This, in turn, requires a radical change in the way people live, as well as the adoption of specific measures to ensure the reduction of air pollution. In this regard, the objective of this study was to perform a comprehensive analysis of the ecological and hygienic conditions of atmospheric air and evaluate its impact on human health due to pollution. The study incorporated empirical research methods such as empirical description and comparison to analyze emissions of pollutants, assess population morbidity rates, and conduct correlation and regression analyses. Official data from the State Committee of Uzbekistan on Statistics and scientific papers were utilized, alongside statistical analysis techniques and logical reasoning to investigate atmospheric air pollution and its impact on public health. The study analysed the indicators of emissions of pollutants into the atmosphere in the Republic of Uzbekistan as a whole and by regions. Furthermore, the paper provides a detailed analysis of the general morbidity of the population of the Republic of Uzbekistan and indicators of the incidence of cardiovascular diseases, based on which a correlation and regression analysis was performed. In addition, the morbidity rates of the population with diseases of the respiratory system and eye diseases throughout the Sirdaryo Region were analysed. The study revealed that Uzbekistan experiences high levels of environmental pollution, with a direct correlation found between atmospheric pollutants and the incidence of cardiovascular diseases, respiratory organ issues, and eye conditions. To protect the atmosphere, reducing pollutant emissions and implementing sustainable development principles, such as industrial modernization and the use of alternative energy sources, are necessary. The results highlight the importance of identifying pollutant types, their properties, and release conditions for effective pollution assessment. The practical significance of this study is to optimize the data of environmental monitoring of urban air pollution in the Republic of Uzbekistan, where in general there is a high level of pollutants in the atmosphere, which affects the health of the population.

Irritant asthma and work: cases from the UK SWORD reporting scheme from 1999 to 2018

BackgroundAcute irritant asthma is a preventable health consequence of a workplace exposure and has a number of adverse outcomes. While cases and case series are reported, little is known about...

Choosing Data Clustering Tools For GIS-Based Visualization Of Disease Incidence In The Population

Objective — To substantiate the choice of optimal tools for clustering spatially referenced data on disease incidence for GIS-based analysis of their spatial distribution. Material and Methods — We used primary data on the incidence of malignant neoplasms, chronic alcoholism, and asthma in the population of eight administrative areas in Arkhangelsk Oblast as a constituent entity of the Arctic Zone of the Russian Federation. Disease incidence was averaged over a 5-year period from 2016 to 2020. We assessed the methods for visualizing the distribution of spatially referenced indicators using the ArcMap geoinformation system tools. Results — The study yielded differences in the outcomes of automated clustering of spatially referenced data in ArcMap, depending on the normality of the distribution in individual samples and the spread of indicator values, which was visually reflected on the resulting map. The parameter values in the samples directly affected the features of data clustering. Hence, this issue is important to consider for ensuring the correct choice of the appropriate analytical tool. Conclusion — Our study demonstrated that when using tools for automated clustering of spatially referenced incidence data in terms of their visualization in ArcGIS, it is necessary to consider the factors that directly affect the accuracy of their presentation. We consider it most appropriate to use a clustering tool based on the geometric interval method.

Increased Risk of New-Onset Asthma After COVID-19: A Nationwide Population-Based Cohort Study

Previous studies have suggested that respiratory virus infections may be associated with new-onset asthma. However, whether coronavirus disease 2019 (COVID-19) is associated with an increased risk of new-onset asthma remains unclear. We aimed to evaluate whether recent COVID-19 increases the risk of new-onset asthma and whether COVID-19 vaccination could mitigate this risk. We constructed 3 different study designs using the Korean National Health Insurance claim-based database: study 1: COVID-19-diagnosed subjects (COVID-19 cohort) and their matched controls; study 2: COVID-19-vaccinated subjects (vaccination cohort) and their matched controls; and study 3: vaccination cohort and their matched controls, excluding subjects diagnosed with COVID-19. In study 1, 1.6% of the COVID-19 cohort and 0.7% of the matched cohort developed new-onset asthma, with incidences of 31.28 and 14.55 per 1,000 person-years, respectively (P < .001). The COVID-19 cohort had a higher risk of new-onset asthma (adjusted hazard ratio [aHR] 2.14; 95% CI 1.88-2.45) than matched controls. In study 2, the vaccination cohort had a lower risk of new-onset asthma than the matched controls (aHR 0.82; 95% CI 0.76-0.89). However, among subjects without a COVID-19 diagnosis, COVID-19 vaccination was not associated with a reduced risk of new-onset asthma in study 3 (aHR 0.95; 95% CI 0.87-1.04). In subgroup analysis, the risk of new-onset asthma was significantly lower in fully vaccinated subjects and higher in older subjects and in those with diabetes mellitus than in their counterparts. The COVID-19 was associated with a higher incidence of new-onset asthma, which might be preventable by COVID-19 vaccination.