Autistic individuals have increased risk of COVID-19

Autistic adults, adults with intellectual disability, and adults with mental health diagnoses have multiple risk factors for infection with COVID-19 and for experiencing more severe disease if they contract COVID-19, according to research from the A.J. Drexel Autism Institute at Drexel University.

Identifying risk factors for COVID-19 among autistic adults, adults with intellectual disability and adults with psychiatric diagnoses is important for prioritizing public health initiatives and clinical practice—including vaccination, testing, masking and distancing. Additionally, awareness of risks can help with decision-making in caring for these populations.

Researchers used data from Medicaid to look at whether these groups were more likely to experience risk factors for COVID-19 and noted that though the Medicaid data examined is from 2008–2012, risk factors, such as living in a residential facility, are not likely to have lessened over time.

"These high-risk populations should be recognized by clinicians and these groups should be prioritized for vaccine outreach and education," said Whitney Schott, Ph.D., a research scientist at the Autism Institute and lead author on the study.

The data showed that autistic adults had higher odds of living in a residential facility, receiving in-home services from outside caregivers, having had an avoidable hospitalization and having a high-risk health condition, compared to neurotypical adults without mental health conditions.

It also showed adults with intellectual disability had similar odds of having these conditions. Adults with other mental health conditions were also more likely to live in a residential facility, receive services from outside caregivers and have had avoidable hospitalizations compared to the neurotypical population without mental health conditions. They had three times higher odds of having a high-risk health condition.

Researchers examined risk factors for COVID-19 among adults enrolled in Medicaid from 2008–12 who were ages ages 20–64 with autism, intellectual disability, mental health conditions and with no mental health conditions. They estimated prevalence, as well as logistic regressions for these groups to find the odds of these risk factors. From a random sample, 372,807 had any mental health condition; 683,778 did not. Of the full population of autistic adults and adults with intellectual disability, 31,101 were autistic, 52,049 were autistic with intellectual disability, and 563,558 were diagnosed with intellectual disability but not autism.

"Care providers, policymakers and advocates should be aware of the higher rates—among autistic adults, adults with intellectual disability and adults with mental health diagnoses—of risk factors for contracting COVID-19 and more severe illness if infected," said Lindsay Shea, DrPH, director of the Policy and Analytics Center and leader of the Life Course Outcomes Research Program at the Autism Institute, an associate professor and co-author of the report.

It is important to intensify outreach efforts to vaccinate these vulnerable groups, added Shea. Trusted providers with preexisting relationships may be in the best position to help those in this population become vaccinated. Efforts should also be made to provide up-to-date information about safe practices, such as wearing face-coverings, maintaining physical distance, handwashing, avoiding crowds and increasing ventilation.

The report, "COVID-19 Risk: Adult Medicaid Beneficiaries with Autism, Intellectual Disability, and Mental Health Conditions" was published in Autism in August 2021.