Clinical Characteristics, Risk Factors, and Long-Term Outcomes of Childhood Asthma: A Prospective Cohort Study

Background: Childhood asthma is one of the most common chronic respiratory diseases affecting children worldwide and is a major cause of recurrent hospital visits, school absenteeism, and impaired quality of life. Early identification of clinical characteristics and modifiable risk factors is essential for improving long-term disease control.

Objectives: To evaluate the clinical characteristics, identify risk factors, and assess the long-term outcomes of childhood asthma in children attending a tertiary care teaching hospital.

Materials and Methods: This prospective cohort study was conducted in the Department of Pediatrics, ESIC Medical College and Hospital, Kalaburagi, Karnataka, India, from April 2025 to March 2026. A total of 120 children aged 5–15 years with physician-diagnosed asthma were enrolled and followed for 12 months. Demographic characteristics, clinical features, environmental exposures, laboratory investigations, pulmonary function tests, treatment adherence, and follow-up outcomes were recorded. Statistical analysis was performed using SPSS version 26.0, with p<0.05 considered statistically significant.

Results: The mean age of participants was 9.6±2.8 years, with males constituting 60.0%. Family history of asthma or atopy was present in 50.8%, allergic rhinitis in 48.3%, passive smoking exposure in 39.2%, and elevated serum IgE in 61.7% of children. At baseline, 43.4% had uncontrolled asthma, which declined to 9.2% after one year of follow-up. Well-controlled asthma increased from 18.3% at enrollment to 67.5% at 12 months. Improved lung function was observed in 65.8% of children, while 79.2% remained free from hospitalization during follow-up. Significant predictors of poor asthma control included passive smoking (p=0.018), family history of asthma (p=0.031), allergic rhinitis (p=0.047), poor medication adherence (p<0.001), and elevated serum IgE levels (p=0.039).

Conclusion: Childhood asthma demonstrates favorable long-term outcomes with regular follow-up, adherence to controller therapy, and appropriate disease monitoring. Environmental exposures, allergic comorbidities, elevated IgE levels, and poor treatment adherence significantly contribute to poor asthma control. Early risk factor identification and comprehensive asthma management may substantially improve clinical outcomes