Abstract
Introduction: COVID-19 disease may have long-term consequences, called long COVID. They concern symptoms (most often neurological and neuropsychiatric) lasting ≥12 weeks without another diagnosis and a predictable time of resolution. They become a diagnostic and therapeutic problem in patients with previously observed behavioral disorders, e.g. in people with autism spectrum disorders (ASD). Most published studies on long COVID mainly focus on adults, and there is limited information on the pediatric population. There is also not much information in the available literature about long COVID in people with autism spectrum disorders. The main aim of this narrative review is to present the problem of long COVID in people with autism spectrum disorders. Method: Based on a review of the current literature based on the EBM (Evidence-Based Medicine) paradigm, the problem of long COVID in autism spectrum disorders is presented. During data collection, the PubMed search engine, which supports the MEDLINE database, and the Google Scholar search engine were used. The criteria used to search for articles are works published since 2022, available in Polish or English. Results: The pandemic has deepened behavioral disorders related to the autism spectrum disorders. The occurrence of COVID-19 and subsequent symptoms associated with long COVID was and is more common in people with ASD. Conclusions: COVID-19 has a significant impact on neuropsychiatric symptoms in people with autism spectrum disorders. Difficulties have been observed in the treatment of long COVID in patients with ASD. There is a need to increase the awareness of parents, health care workers, and scientists about the effects of SARS-CoV-2 infection in the population of people with autism spectrum disorders. This is necessary to understand the consequences of the disease, speed up diagnosis and provide appropriate specialist help.
References
Ablin, J.N., Zohar, A.H., Zaraya-Blum. R., Buskila, D. (2016). Distinctive personality profiles of fibromyalgia and chronic fatigue syndrome patients. PeerJ, 4:e2421. https://doi.org/10.7717/peerj.2421
Aiyegbusi, O.L., Hughes, S.E., Turner, G., Rivera, S.C., McMullan, C., Chandan, J.S., Haroon, S., Price, G., Davies, E.H., Nirantharakumar, K., Sapey, E., Calvert, M.J. (2021). Symptoms, complications and management of long COVID: a review. Journal of the Royal Society of Medicine, 114(9), 428-442. https://doi.org/10.1177/01410768211032850
Aslan Genç, H., Doenyas, C., Aksu, Y., Musaoğlu, M.N., Uzunay, S., Mutluer, T. (2023). Long-term Behavioral Consequences of the COVID-19 Pandemic for Autistic Individuals and Their Mothers. Journal of Autism and Developmental Disorders, 4, 1-13. https://doi.org/10.1007/s10803-018-3605-y
Astin, R., Banerjee, A., Baker, M.R., Dani, M., Ford, E., Hull, J.H., Lim, P.B., McNarry, M., Morten, K., O’Sullivan, O., Pretorius, E., Raman, B., Soteropoulos, D.S., Taquet, M., Hall, C.N. (2023). Long COVID: mechanisms, risk factors and recovery. Experimental Physiology, 108(1), 12-27. https://doi.org/10.1113/EP090802
Ceban, F., Ling, S., Lui, L.M.W., Lee, Y., Gill, H., Teopiz, K.M., Rodrigues, N.B., Subramaniapillai, M., Vincenzo, J.D.D., Cao, B., Lin, K., Mansur, R.B., Ho, R.C., Rosenblat, J.D., Miskowiak, K.W., Vinberg, M., Maletic, V., McIntyre, R.S. (2022). Fatigue and cognitive impairment in post-COVID-19 Syndrome: A systematic review and meta-analysis. Brain, Behavior, and Immunity, 101, 93-135. https://doi.org/10.1016/j.bbi.2021.12.020
Colizzi, M., Sironi, E., Antonini, F., Ciceri, M.L., Bovo, C., Zoccante, L. (2020). Psychosocial and behavioral impact of COVID-19 in autism spectrum disorder: An online parent survey. Brain Sciences, 3, 10(6), 341. https://doi.org/10.3390/brainsci10060341
Grant, S., Norton, S., Weiland, R.F., Scheeren, A.M., Begeer, S., Hoekstra, R.A. (2022) Autism and chronic ill health: an observational study of symptoms and diagnoses of central sensitivity syndromes in autistic adults. Molecular Autism, 13(1),7. https://doi.org/10.1186/s13229-022-00486-6.
Helms, J., Kremer, S., Merdji, H., Clere-Jehl, R., Schenck, M., Kummerlen, C., Collange, O., Boulay, C., Fafi-Kremer, S., Ohana, M., Anheim, M., Meziani, F. (2020). Neurologic features in severe SARS-CoV-2 infection. The New England Journal of Medicine, 382, 2268-2270. https://doi.org/10.1056/NEJMc2008597
Jyonouchi, H., Geng, L., Rose, S., Bennuri, S.C., Frye, R.E. (2019). Variations in mitochondrial respiration differ in IL-1ß/IL-10 ratio based subgroups in autism spectrum disorders. Frontiers in Psychiatry, 10. https://doi.org/10.3389/fpsyt.2019.00071
Jyonouchi, H., Geng, L., Rossignol, D.A., Frye, R.E. (2022). Long COVID Syndrome Presenting as Neuropsychiatric Exacerbations in Autism Spectrum Disorder: Insights for Treatment. Journal of Personalized Medicine, 12, 1815. https://doi.org/10.3390/jpm12111815
Karpur, A., Lello, A., Frazier, T., Dixon, P.J., Shih, A.J. (2018). Health disparities among children with autism spectrum disorders: Analysis of the National Survey of Children’s Health 2016. Journal of Autism and Developmental Disorders, 49(4), 1652-1664. https://doi.org/10.1007/s10803-018-3862-9
Karpur, A., Vasudevan, V., Shih, A., Frazier, T. (2022). Brief Report: Impact of COVID-19 in Individuals with Autism Spectrum Disorders: Analysis of a National Private Claims Insurance Database. Journal of Autism and Developmental Disorders, 52(5), 2350-2356. https://doi.org/10.1007/s10803-021-05100-x
Kundu, A., Maji, S., Kumar, S., Bhattacharya, S., Chakraborty, P., Sarkar, J. (2022). Clinical aspects and presumed etiology of multisystem inflammatory syndrome in children (MIS-C): A review. Clinical Epidemiology and Global Health, 14, 100966. https://doi.org/10.1016/j.cegh.2022.100966
Lima, M.E.S., Barros, L.C.M., Aragao, G.F. (2020). Could autism spectrum disorders be a risk factor for COVID-19? Medical Hypotheses, 144, 109899. https://doi.org/10.1016/j.mehy.2020.109899
Lopez-Leon, S., Wegman-Ostrosky, T., Ayuzo Del Valle, N.C., Perelman, C., Sepulveda, R., Rebolledo, P.A., Cuapio, A., Villapol, S. (2022). Long-COVID in children and adolescents: a systematic review and meta-analyses. Scientific Reports, 12, 9950. https://doi.org/10.1038/s41598-022-13495-5
Ludvigsson, J.F. (2021). Case report and systematic review suggest that children may experience similar long-term effects to adults after clinical COVID-19. Acta Paediatrica, 110(3), 914-921. https://doi.org/10.1111/apa.15673
Mutluer, T., Doenyas, C., Aslan Genc, H. (2020). Behavioral implications of the Covid-19 process for autism spectrum disorder, and individuals’ comprehension of and reactions to the pandemic conditions. Frontiers in Psychiatry, 11, 561882. https://doi.org/10.3389/fpsyt.2020.561882
Nollace, L., Cravero, C., Abbou, A., Mazda-Walter, B., Bleibtreu, A., Pereirra, N., Giannitelli, M. (2020). Autism and COVID-19: A case series in a neurodevelopmental unit. Journal of Clinical Medicine, 9(9), 2937. https://doi.org/10.3390/jcm9092937
Peterson, J.L., Earl, R.K., Fox, E.A., Ma, R., Haidar, G., Pepper, M., Berliner, L., Wallace, A.S., Bernier, R.A. (2019). Trauma and autism spectrum disorder: Review, proposed treatment adaptations and future directions. Journal of Child and Adolescent Trauma, 12(4), 529-547. https://doi.org/10.1007/s40653-019-00253-5
Roesch Ely, D., Kramer, B., Jaehn, A., Merle, U., Weisbrod, M. (2022). Post-Covid Syndrome: A standardized assessment on subjective psychiatric and neuropsychological symptoms. European Psychiatry, 65(S1), S530-S531. https://doi.org/10.1192/j.eurpsy.2022.1355
Rosen, N.E., Lord, C., Volkmar, F.R. (2021). The diagnosis of autism: From Kanner to DSM-III to DSM-5 and beyond. Journal of Autism and Developmental Disorders, 51, 4253-4270. https://doi.org/10.1007/s10803-021-04904-1
Sharma, P., Bharti, S., Garg, I. (2022). Post COVID fatigue: Can we really ignore it? Indian Journal of Tuberculosis, 69(2), 238-241. https://doi.org/10.1016/j.ijtb.2021.06.012
Shea, L.L., Xie, M., Turcotte, P., Marcus, S., Field, R., Newschaffer, C., Mandell, D. (2018). Brief report: Service use and associated expenditures among adolescents with autism spectrum disorder transitioning to adulthood. Journal of Autism and Developmental Disorders, 48(9), 3223-3227. https://doi.org/10.1007/s10803-018-3563-4
Valenti, M., Ciprietti, T., Egidio, C.D., Gabrielli, M., Masedu, F., Tomassini, A.R., Sorge, G. (2012). Adaptive response of children and adolescents with autism to the 2009 earthquake in L’Aquila, Italy. Journal of Autism and Developmental Disorders, 42(6), 954-960. https://doi.org/10.1007/s10803-011-1323-9
Venkataramani, V., Winkler, F. (2022). Cognitive Deficits in Long Covid-19. The New England Journal of Medicine, 10, 387(19), 1813-1815. https://doi.org/10.1056/NEJMcibr2210069
Zimmermann, P., Pittet, L.F., Curtis, N. (2021). How common is long COVID in children and adolescents? The Pediatric Infectious Disease Journal, 40(12), 482-487. https://doi.org/10.1097/INF.0000000000003328