Autism and COVID-19

Protective factors for children with autism spectrum disorder during COVID-19-related strict lockdowns: a Shanghai autism early developmental cohort study

BACKGROUND

COVID-19 lockdowns increased the risk of mental health problems, especially for children with autism spectrum disorder (ASD). However, despite its importance, little is known about the protective factors for ASD children during the lockdowns.

METHODS

Based on the Shanghai Autism Early Developmental Cohort, 188 ASD children with two visits before and after the strict Omicron lockdown were included; 85 children were lockdown-free, while 52 and 51 children were under the longer and the shorter durations of strict lockdown, respectively. We tested the association of the lockdown group with the clinical improvement and also the modulation effects of parent/family-related factors on this association by linear regression/mixed-effect models. Within the social brain structures, we examined the voxel-wise interaction between the grey matter volume and the identified modulation effects.

RESULTS

Compared with the lockdown-free group, the ASD children experienced the longer duration of strict lockdown had less clinical improvement (β = 0.49, 95% confidence interval (CI) [0.19-0.79], p = 0.001) and this difference was greatest for social cognition (2.62 [0.94-4.30], p = 0.002). We found that this association was modulated by parental agreeableness in a protective way (-0.11 [-0.17 to -0.05], p = 0.002). This protective effect was enhanced in the ASD children with larger grey matter volumes in the brain's mentalizing network, including the temporal pole, the medial superior frontal gyrus, and the superior temporal gyrus.

CONCLUSIONS

This longitudinal neuroimaging cohort study identified that the parental agreeableness interacting with the ASD children's social brain development reduced the negative impact on clinical symptoms during the strict lockdown.

Prevalence and severity of COVID-19 among children and adolescents with autism spectrum disorders in the Republic of Korea

LAY ABSTRACT

It is more difficult to prevent coronavirus disease 2019 in children and adolescents with autism spectrum disorder, as they have trouble communicating and adjusting to their new daily lives like wearing masks and social distancing. However, there have not been many studies that focused on coronavirus disease 2019 among children and adolescents with autism spectrum disorder. We included all Korean citizens under the age of 19 as our study subjects. Among them, we found out the prevalence, severity, and case fatality of coronavirus disease 2019 in children and adolescents with and without autism spectrum disorder. The prevalence of coronavirus disease 2019 among children and adolescents with autism spectrum disorder was lower than that of those without autism spectrum disorder. For severity, children and adolescents with autism spectrum disorder were more likely to enter severe stages of disease and had higher hospitalization rates than those without autism spectrum disorder. There were no deaths among children and adolescents with autism spectrum disorder, while a few died among children and adolescents without autism spectrum disorder. However, due to the small number of deaths, it was difficult to determine whether there was a link between autism spectrum disorder and coronavirus disease 2019 deaths. We found that the appropriate quarantine policies have played a great role in sustaining overall low prevalence and higher hospitalization rates among children and adolescents with autism spectrum disorder than those without autism spectrum disorder. Furthermore, because Korea has fewer schools and facilities (i.e. personal care, social training, and skilled nursing facility) for children and adolescents with autism spectrum disorder than other countries, those with autism spectrum disorder have fewer social contacts than even before the COVID-19 pandemic.

Global prevalence of autism spectrum disorder and its gastrointestinal symptoms: A systematic review and meta-analysis

BACKGROUND

Autism spectrum disorder (ASD) is a severe public health concern, and Gastrointestinal (GI) symptoms are becoming more common among co-morbidities. The evidence has to be updated depending on differences in different parts of the world. This systematic review and meta-analysis aimed to better understand the existing epidemiological condition and help make health-related decisions.

METHODS

Searches in PubMed, Web of Science, Embase databases are limited to 14 March 2022. We reviewed the global prevalence of ASD and the prevalence of GI in people with ASD. Data were extracted by two independent researchers. Literature quality assessment using the National Institutes of Health Study Quality Assessment Tool.

RESULTS

We discovered that the global pooled prevalence of ASD was 98/10,000 (95% confidence interval, 95%CI: 81/10,000-118/10,000, I ² = 99.99%, p < 0.001), with 48.67% (95%CI: 43.50 -53.86, I ² = 99.51%) of individuals with ASD reporting GI symptoms. Based on the subgroup analyses, we found a higher prevalence of ASD in males (90/10,000, 95%CI: 71/10,000-112/10,000, I ² = 99.99%) than females (21/10,000, 95%CI: 15/10,000-27/10,000, I ² = 99.99%). Prevalence of pooling is higher in developing countries (155/10,000, 95% CI: 111/10,000-204/10,000, I ² = 99.87%) than in developed countries (85/10,000, 95%CI: 67/10,000-105/10,000, I ² = 99.99%).

CONCLUSION

The global prevalence of ASD and the prevalence of GI symptoms in ASD are both significant. The prevalence of ASD is much higher in men than in women. Further attention to ASD and its related comorbidities will be required in the future to inform coping strategy adaptation.