Abstract
Background Asthma diagnosis in children under five remains a challenge because of frequent viral wheeze and the inability to perform spirometry. Asthma predictive scores, including the latest Global Initiative for Asthma (GINA) guidelines in children under five, are based on risk factors and clinical features. Hematologic parameters in this age group with asthma have not been explored, which might aid in the diagnosis. The objective of our study was to evaluate hematologic parameters and the clinical profile in children under five years with wheeze. Methodology A cross-sectional study of children with wheeze aged zero to five years was conducted at a tertiary care teaching institution from 1 January 2025 to 31 December 2025. Sociodemographic, clinical, and hematological parameters of children were assessed. Results Results were obtained from 120 children. The median age of children was 47 months (2-60 months), with a male-to-female ratio of 1.18:1. Cough, fever, fast breathing, and exercise intolerance were observed in 82.5%, 32.5%, 30.8%, and 11.7% of children, respectively. A positive family history of allergy or asthma was noted in 28.3% cases. Comorbidities such as allergic rhinitis, atopic dermatitis, and urticaria were associated with 15 (12.5%), 12 (10.0%), and nine (7.5%) children, respectively. Hematologic abnormalities such as anemia were observed in 40% of children, while leucocytosis was present in 41.66%, making it the most common abnormality. Fever, urticaria, and anemia were significantly associated with a higher probability of asthma. Conclusion Cough was the most common presenting symptom, while anemia and leucocytosis were the most frequent hematological abnormalities. Fever, urticaria, and anemia were significantly associated with higher asthma probability categories.