ArticleJournal of asthma and allergy2026
Bronchial Hyperreactivity in the COVID-19 Era: The Impact of SARS-CoV-2 Infection and COVID-19 Vaccination in Patients with Respiratory Symptoms.
Article in Journal of asthma and allergy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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9 authors.
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Abstract
Introduction: Persistent respiratory symptoms are commonly reported following coronavirus disease 2019 (COVID-19). Although COVID-19 vaccines are effective, concerns remain regarding their potential impact on airway hypersensitivity. The relationship between SARS-CoV-2 infection, vaccination, and bronchial hyperresponsiveness remains unclear. Materials and Methods: This retrospective study included adults aged ≥18 years who underwent methacholine provocation testing. Participants were categorized into four groups according to their history of SARS-CoV-2 infection and COVID-19 vaccination: no infection/no vaccination (NI-NV), vaccination/no infection (V-NI), no vaccination/infection (NV-I), and vaccination/infection (V-I). Airway hypersensitivity was defined as a ≥20% reduction in forced expiratory volume in one second (FEV1) following methacholine challenge. Multivariable logistic regression analysis was performed to evaluate independent associations. Results: A total of 340 participants were included (NI-NV: n=36; V-NI: n=163; NV-I: n=25; V-I: n=116). No significant differences were observed in methacholine positivity, pulmonary function parameters, or PC20 values across groups (all p>0.05). In multivariable analysis, neither prior infection (adjusted OR 0.99, 95% CI 0.63-1.55) nor vaccination (adjusted OR 1.06, 95% CI 0.60-1.88) was independently associated with bronchial hyperresponsiveness. Smoking was significantly associated with methacholine positivity (adjusted OR 3.33, 95% CI 1.43-7.77). Symptom severity differed among groups, with higher cough and sputum scores in the NI-NV group and greater dyspnea severity in the NV-I group. Conclusion: Neither prior SARS-CoV-2 infection nor COVID-19 vaccination was associated with increased airway hypersensitivity after adjustment for confounders. Despite similar objective airway responsiveness, symptom severity varied across groups, suggesting a dissociation between subjective respiratory symptoms and measurable bronchial hyperresponsiveness.
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