Does Covid affect more people with autism?

Over the past year or so, with high levels of uncertainty, anxiety, social isolation and financial pressure, the mental health of people around the world remains fragile. Although we all feel it, we are not all equal in this crisis. 

Autism is a human developmental disorder characterized by difficulties in social interaction and communication. While it may not be obvious at first glance that people with autism suffer more from the pandemic, it is a reality. But to what extent?

 

Autism causes several changes at the genetic level, but also at the immune level; the deregulation of inflammatory cytokines is one of these changes. A large number of cytokines can lead to a "cytokine storm", i.e. an excessive release of these hormones involved in immune responses. The cytokine storm is now becoming more widely known as a cause of complications of covid-19. Thus, autistic people would be more likely to develop complications. Beware of jumping to conclusions, the research is recent, and new studies suggest that the "cytokine storm", which was thought to be a real aggravating symptom of covid, seems not to be.

 

Another study speculates that melatonin problems in autism may lead to complications. Also known as the sleep hormone, melatonin plays an important role in the body's innate defense system. Low melatonin levels may make people more susceptible to covid. In some people with autism, melatonin is synthesized differently. In addition, frequent sleep disturbances also contribute to the decrease in production of this hormone. Thus, low melatonin production may lead to an increased susceptibility to Covid-19 disease. However, these recent researches are only hypotheses.

 

But then if nothing is certain, what do we really know about the consequences of Covid on people with autism? Perhaps not much, but certainly, not nothing.

 

People with autism have more difficulty dealing with unexpected changes and uncertainty. Uncertainty plays a key role in mental health. In addition, social rules, which autistic people have integrated with more difficulty than non-autistic people, have changed too abruptly for people who like to be habitual and have difficulty with change. "Maybe [autistic people] only eat certain things or wear a certain brand of socks, and they can't get them anymore," said Dr. Giwa Onaiwu. Of course, people with autism also feel the effects of social isolation and loneliness, which can lead to suicidal thoughts and behaviors.

 

Some accommodations have already been made to combat their increased psychological distress: in the early confinements, their outings were not limited to 1 hour, nor were they restricted to 1km from home, nor were their frequencies and purposes regulated.

 

But the covid could have had at least one advantage for autistic people. Today, everywhere visios, teleconferences, education and online meetings are used "as a recourse", one must "resign oneself" to telework. However, visios are a good means of communication for people with social difficulties.

 

Many autistic people have been asking for the possibility of using video for years; in fact, the Internet would help autistic people to communicate more than non-autistic people, especially because it is an opportunity to meet people who are similar to us, but also because everything is written down and we have more time to think. Only the requested visual accommodations never came to anything, until the day when non-autistic people needed them, which highlights the system of privileges of neurotypicals that has always existed.

 

So the idea of having only forced telecommuting for the rest of our lives is not at all attractive. But the pandemic may have shown us that remote work does not necessarily mean abuse and bad work. Perhaps this is an opportunity to build a more inclusive post-pandemic society, one that allows for remote participation by those who want it. As Dr. Kapp says, "For some people, a remote opportunity can make a difference in whether they participate."

 

References:

 

Smile, Sharon C. "Supporting children with autism spectrum disorder in the face of the COVID-19 pandemic." CMAJ 192.21 (2020): E587-E587.

 

Cassidy, Sarah A., et al. "An expert discussion on autism in the COVID-19 pandemic." Autism in Adulthood 2.2 (2020): 106-117.

 

de Sousa Lima, Matheus Eugênio, Levi Coelho Maia Barros, and Gislei Frota Aragão. "Could autism spectrum disorders be a risk factor for COVID-19?." Medical hypotheses 144 (2020): 109899.

 

Brown, Gregory M., et al. "Autism Spectrum Disorder patients may be susceptible to COVID-19 disease due to deficiency in melatonin." Medical Hypotheses 149 (2021): 110544.

 

Sinha, Pratik, Michael A. Matthay, and Carolyn S. Calfee. "Is a “cytokine storm” relevant to COVID-19?." JAMA internal medicine 180.9 (2020): 1152-1154.