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We investigated the neuro-immune axis in pediatric asthma to determine if the magnitude of post-SARS-CoV-2 humoral immunity correlates with objective airway afferent nerve hypersensitivity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective observational study included 61 pre-pubertal children (aged 8 to\u2009&lt;\u200912\u00a0years) with well-controlled, predominantly inhaled corticosteroid (ICS)-treated (93.4%) bronchial asthma and confirmed past SARS-CoV-2 infection. Systemic humoral memory was quantified via anti-Spike IgG and IgA titers. Objective cough reflex sensitivity was measured using a capsaicin challenge test, establishing C2 and C5 values. Subjective symptom burden was evaluated using parent-proxy questionnaires (PCQ, VAS, PedsQL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Stratification by median anti-Spike IgG (125.77 BAU\/ml) revealed no significant differences in basal (C2,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.301) or motor response (C5,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.714) capsaicin thresholds between robust and waning humoral memory states. IgA stratification yielded identical results. Spearman\u2019s correlation confirmed a complete lack of association between absolute IgG titers and neurophysiological markers (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.05). Crucially, parent-reported chronic cough severity (PCQ, VAS) and asthma-specific quality of life demonstrated a complete dissociation from objective capsaicin thresholds across all evaluated domains (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.05). Supplementary subgroup analysis revealed no significant differences in cough thresholds based on acute COVID-19 severity (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A robust post-viral humoral immune response to SARS-CoV-2 does not precipitate peripheral airway nerve hypersensitivity in properly controlled, ICS-treated asthmatic children. The complete uncoupling of subjective parent-reported symptoms from objective neurophysiology cautions against diagnosing neurogenic Long COVID based solely on questionnaires, emphasizing the necessity of objective testing and evaluation of alternative atopic etiologies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00408-026-00901-2","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T01:20:18Z","timestamp":1782264018000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Serological Profiling and Neuro-Immune Resilience: The Dissociation Between Anti-SARS-CoV-2 Antibodies and Post-Viral Airway Hyperresponsiveness in Pediatric Asthma"],"prefix":"10.1007","volume":"204","author":[{"given":"Peter","family":"Kunc","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaroslav","family":"Fabry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jana","family":"Mazuchova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Pec","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4257-3213","authenticated-orcid":false,"given":"Renata","family":"Pecova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,24]]},"reference":[{"key":"901_CR1","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1016\/S2213-2600(21)00125-9","volume":"9","author":"W-J Song","year":"2021","unstructured":"Song W-J, Hui CKM, Hull JH et al (2021) Confronting COVID-19-associated cough and the post-COVID syndrome: role of viral neurotropism, neuroinflammation, and neuroimmune responses. 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