Hospitalization and Mortality for Insured Patients in the United States with COVID-19 with and without Autism Spectrum Disorder.
Amber Davis, Kathryn Van Eck, Nikeea Copeland-Linder and 2 others
PMID 37022580WHAT IT FOUND
Adults with autism had higher odds of dying from COVID-19 than those without, even after accounting for other health conditions.
The link to hospitalization disappeared once other chronic illnesses were considered, suggesting comorbidities drive hospital risk more than autism itself.
Key findings
01After adjusting for sociodemographics and comorbidities, individuals with ASD had significantly higher odds of COVID-19 mortality (OR 1.81) but no significant difference in hospitalization odds.
02The number of chronic comorbidities showed a strong dose-response relationship with both hospitalization and mortality, with five or more conditions associated with 23.71 times higher odds of hospitalization and 52.50 times higher odds of death.
03Before adjusting for comorbidities, ASD was associated with 3.04 times higher odds of hospitalization and 3.87 times higher odds of death compared to those without ASD.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study only included privately insured individuals, who may have better access to healthcare and different health profiles than the general population, limiting generalizability. ASD status was determined by insurance claims codes, which may not accurately reflect the severity or specific characteristics of autism, such as intellectual disability. The study could not determine the co-occurrence of intellectual disability because comorbidity data was aggregated. The data did not include all private payors, so not all privately insured individuals in the US were represented.
Declared interests
The authors declared no conflicts of interest. The study used data from FAIR Health, Inc., a nonprofit organization.
The easy way to misread this
Do not conclude that autism itself directly causes higher hospitalization rates for COVID-19. The study showed that the increased risk of hospitalization disappeared once other chronic health conditions were taken into account, indicating that comorbidities are the primary driver of hospital risk in this population.