Post-COVID-19 Onset of Allergic Conditions in a Propensity-Matched Cohort of Children and Adults.

Publication date: May 25, 2026

SARS-CoV-2 offers a new context to examine the relationship between viral infection and allergic disease. A biologically plausible mechanism exists for post-infectious Th2-skewed responses, among other forms of immune dysregulation, and early studies suggest increases in asthma and other allergic or atopy-associated diagnoses following infection. To investigate whether COVID-19 infection predisposes individuals to developing allergic conditions. We conducted a 1:2 propensity-matched retrospective cohort study of individuals 1 to 64 years evaluating the association of COVID-19 exposure and development of incident allergic conditions (atopic dermatitis, asthma, food allergies, rhinoconjunctivitis, medication allergies, or urticaria) within a follow-up period of 18 months. We calculated hazard ratios for the incident outcomes of interest amongst the entire cohort as well as sub-analyses in children and active-duty service members. COVID-19 infection was associated with significantly increased hazard ratios for all six allergic conditions in the full cohort. Among the active-duty subset, asthma and rhinoconjunctivitis were significantly associated with infection. In children, all conditions except food allergies were significantly associated with infection. Higher sponsor rank, evaluated as a potential surrogate for socioeconomic status, showed a slight protective effect against the development of asthma. This study adds to the growing body of evidence illustrating the risk for development of allergic conditions after COVID-19 infection in both children and adults. Our findings highlight the potential public health burden of these conditions, emphasize the importance of monitoring for allergic diseases after COVID-19 infection to enable prompt intervention, and suggest a mechanistic link between COVID-19 infection and type 2 inflammation.

Concepts Keywords
Food allergic rhinitis
Immunol allergy
Months asthma
Rhinoconjunctivitis atopic dermatitis
Viral atopy
COVID-19
food allergies
medication allergies
SARS-CoV-2
Th2 response
type 2 inflammation
urticaria

Semantics

Type Source Name
disease MESH COVID-19
disease MESH viral infection
disease MESH asthma
pathway KEGG Asthma
disease MESH infection
disease MESH atopic dermatitis
disease MESH food allergies
disease MESH allergies
disease MESH urticaria
disease MESH inflammation
disease MESH Long Covid
disease MESH allergic rhinitis

Original Article

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