The goal of this research was to determine whether or not enrollment, retention, or success on the National Board for Respiratory Care credentialing examinations were affected by the COVID-19 pandemic and the instructional changes implemented in response to it at a Texas associate degree respiratory care program. This research looked at the past to see how well students did on the National Board for Respiratory Care certification exams. Over the course of 5 years, 69 students graduated from a respiratory care associate’s degree program in Texas. A “pre-pandemic” baseline was established by analyzing the 3 school years before the COVID-19 epidemic. The 2019-2020 cohort was designated as “early pandemic,” the 2020-21 cohort as “mid pandemic,” and the 2021-22 cohort as “late pandemic” so that data from the 3 years could be compared. The data were analyzed using descriptive statistics, the Kruskal-Wallis test, and the Mann-Whitney U test (P<.05 level of significance). Applicants to the program dropped dramatically (P=.001) during the early and late pandemic periods, although overall enrolment and retention were unaffected by the COVID-19 epidemic (P =.42 and P=.95, respectively). Low-cut score (P=.005) and high-cut score (P=.007) on the Therapist Multiple-Choice examination were considerably lower in the mid-pandemic group compared to earlier cohorts. There were no discernable differences between the early and mid-pandemic groups in terms of demographic information or online questionnaire responses. The mid-pandemic cohort had a lower first-time pass rate on the Therapist Multiple-Choice assessment than the pre- and post-pandemic cohorts due to the COVID-19 pandemic and the resulting modifications in instruction.