龍嘉麒LUNG, CHIA-CHI楊喬宇YANG, CHIAO-YUCHIAO-YUYANG公共衛生學系碩士班2026-03-172025-01-1020252025-01-03https://handle.ncl.edu.tw/11296/d43e8ghttps://scholars.csmu.edu.tw/handle/123456789/5738研究目的：COVID-19疫情在全球引發了重大公共衛生挑戰，兒童健康在此期間的長期影響逐漸引起重視。本研究旨在分析COVID-19感染及疫苗接種對兒童新發氣喘的風險，並探討不同年齡、性別、種族等群體的風險差異。研究結果期望為兒童氣喘的預防與管理提供科學依據，以減少COVID-19對兒童健康的長期影響。研究方法：本研究採用回溯性世代研究設計，數據來自TriNetX資料庫，涵蓋2021至2022年間美國5至18歲兒童的COVID-19檢測資料。研究對象依COVID-19檢測結果及疫苗接種狀況分為四個研究族群世代進行分析，並透過傾向評分匹配法控制特定混雜因素，平衡不同組別的年齡、性別、種族、社會經濟狀況等基本人口學特徵。研究結果包含新發氣喘、氣喘藥物使用及死亡的發生率，並使用Cox比例風險模型及Kaplan-Meier曲線進行風險比（hazard ratio, HR）評估及生存分析。研究結果：結果顯示，COVID-19感染顯著增加兒童新發氣喘的風險。對於未接種疫苗的COVID-19感染者，其新發氣喘或死亡風險比為2.328（HR= 2.328；95% CI=2.232-2.429），而接種疫苗後感染的兒童風險更高（HR=3.267；95% CI=3.021-3.532）。男性、5至12歲兒童、拉丁裔兒童的氣喘風險相對較高。過去有過敏性鼻炎或異位性皮膚炎的兒童感染後氣喘風險降低，顯示出可能的保護效應。在疫苗接種方面，對於COVID-19陽性的兒童，疫苗接種會增加新發氣喘的風險（HR=1.16；95% CI=1.097-1.227），但在未確診的兒童中，疫苗接種與新發氣喘風險無顯著關聯（HR=1.018；95% CI=0.964-1.075）。結論：COVID-19感染及疫苗接種可能增高兒童新發氣喘的風險，且不同年齡、性別、種族間的風險有所差異。本研究強調在後疫情時期持續關注兒童的長期健康影響，尤其是高風險群體的健康管理。研究結果做為公共衛生政策提供參考，建議針對特定族群實施長期適當的健康管理措施。Objective:The COVID-19 pandemic has posed significant public health challenges worldwide, drawing increasing attention to its long-term impact on children’s health. This study aims to analyze the risk of new-onset asthma in children following COVID-19 infection and vaccination, and to explore risk differences among groups of varying ages, genders, and ethnicities. The find-ings are expected to provide scientific evidence for the prevention and management of pedi-atric asthma, aiming to mitigate the long-term impacts of COVID-19 on children’s health.Methods:This retrospective cohort study uses data from the TriNetX database, covering COVID-19 testing data from U.S. children aged 5 to 18 years between 2021 and 2022. Subjects were di-vided into four cohorts based on COVID-19 test results and vaccination status. Propensity score matching was applied to control for confounding factors, balancing baseline character-istics such as age, gender, race, and socioeconomic status across groups. The primary out-comes include the incidence of new-onset asthma, asthma medication use, and mortality. Cox proportional hazard models and Kaplan-Meier curves were employed to analyze hazard ratios (HRs) and survival.Results:The results indicate that COVID-19 infection significantly increases the risk of new-onset asthma in children. Among unvaccinated children with COVID-19, the hazard ratio for new-onset asthma or death was 2.328 (95% CI=2.232-2.429), while the risk was even higher among vaccinated children with COVID-19 (HR=3.267; 95% CI=3.021-3.532). The risk of new-onset asthma was relatively higher in males, children aged 5 to 12, and Latinx children. Additionally, children with a history of allergic rhinitis or atopic dermatitis had a reduced risk of asthma post-infection, suggesting a potential protective effect. Regarding vaccination, among COVID-19-positive children, vaccination increased the risk of new-onset asthma (HR=1.16; 95% CI=1.097-1.227); however, for uninfected children, vaccination showed no significant association with asthma risk (HR=1.018; 95% CI=0.964-1.075).Conclusion:COVID-19 infection and vaccination may increase the risk of new-onset asthma in children, with variations in risk across different age, gender, and ethnic groups. This study highlights the importance of ongoing attention to the long-term health effects of COVID-19 on children in the post-pandemic period, particularly in high-risk populations. The findings provide val-uable insight for public health policy, recommending sustained, appropriate health manage-ment for specific demographic groups.兒童氣喘新冠肺炎疫苗接種公共衛生COVID-19CHILDRENASTHMAVACCINATIONPUBLIC HEALTHthesis