ADHD as a Risk Factor for Infection With Covid-19

Eugene Merzon, Iris Manor, Ann Rotem, Tzipporah Schneider, Shlomo Vinker, Avivit Golan Cohen, Ari Lauden, Abraham Weizman, Ilan Green, Eugene Merzon, Iris Manor, Ann Rotem, Tzipporah Schneider, Shlomo Vinker, Avivit Golan Cohen, Ari Lauden, Abraham Weizman, Ilan Green

Abstract

Background: ADHD limits the ability to comply with Covid-19 prevention recommendations. We hypothesized that ADHD constitutes a risk factor for Covid-19 infection and that pharmacotherapy may lower that risk. Methods: Study population included all subjects (N = 14,022) registered with Leumit Health Services between February 1st and April 30, 2020, who underwent at least one Covid-19 test. Data were collected from the electronic health records. Purchasing consecutively at least three ADHD-medication-prescriptions during past year was considered drug-treatment. Results: A total of 1,416 (10.1%) subjects (aged 2 months-103 years) were Covid-19-positive.They were significantly younger, and had higher rates of ADHD (adjOR 1.58 (95% CI 1.27-1.96, p < .001) than Covid-19-negative subjects. The risk for Covid-19-Positive was higher in untreated-ADHD subjects compared to non-ADHD subjects [crudeOR 1.61 (95% CI 1.36-1.89, p < .001)], while no higher risk was detected in treated ones [crudeOR 1.07 (95% CI 0.78-1.48, p = .65)]. Conclusion: Untreated ADHD seems to constitute a risk factor for Covid-19 infection while drug-treatment ameliorates this effect.

Keywords: ADHD; Covid-19; prevalence; stimulants.

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Adjusted odds ratios (error bars indicate 95% confidence intervals) for being Covid-19 positive in ADHD treated and untreated patients. Note. Treated ADHD—ADHD treated with pharmacotherapy. CI = confidence interval. **p 

References

    1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.
    1. Borjas G. J. (2020, April). Demographic determinants of testing incidence and COVID-19 infections in New York City neighborhoods (No. 26952). National Bureau of Economic Research.
    1. Centers for Disease Control and Prevention. (2020. a, May 6). Social distancing. (accessed 8 May 2020).
    1. Centers for Disease Control and Prevention. (2020. b, May 14). People who are at higher risk for severe illness. (accessed 5 June 2020).
    1. Centers for Disease Control and Prevention. (2020. c, April 10). Coronavirus disease 2019 in children—United States, February 12–April 2, 2020. Morbidity and Mortality Weekly Report, 69(14), 422–426.10.15585/mmwr.mm6914e4 (accessed 5 June 2020).
    1. Cheng V. C., Wong S. C., Chuang V. W., So S. Y., Chen J. H., Sridhar S., To K. K.-W., Chan J. F.-W., Hung I. F.-N., Ho P.-L., Yuen K. Y. (2020). The role of community-wide wearing of face mask for control of coronavirus disease 2019 (COVID-19) epidemic due to SARS-CoV-2. Journal of Infection, 81(1), 107–114.
    1. Cortese S., Coghill D., Santosh P., Hollis C., Simonoff E. (2020). Starting ADHD medications during the COVID-19 pandemic: Recommendations from the European ADHD Guidelines Group. The Lancet Child & Adolescent Health, 4(6), 15.
    1. Docherty A. B., Harrison E. M., Green C., Hardwick H. E., Pius R., Norman L., Holden K. A., Read J. M., Dondelinger F., Carson G., Merson L., Lee J., Plotkin D., Sigfrid L., Halpin S., Jackson C., Gamble C., Horby P. W., Nguyen-Van-Tam J. S., . . . Semple M. G. (2020). Features of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: Prospective observational cohort study. British Medical Journal, 369, m1985.
    1. Dowd J. B., Andriano L., Brazel D. M., Rotondi V., Block P., Ding X., Liu Y., Mills M. C. (2020). Demographic science aids in understanding the spread and fatality rates of COVID-19. Proceedings of the National Academy of Sciences of the United States of America, 117(18), 9696–9698.
    1. Gang-lip K. (2020, May 28). Restrictions return in South Korea after new spike in COVID-19 cases. Euronews.
    1. Ginsberg Y., Beusterien K. M., Amos K., Jousselin C., Asherson P. (2014. a). The unmet needs of all adults with ADHD are not the same: A focus on Europe. Expert Review of Neurotherapeutics, 14(7), 799–812.
    1. Ginsberg Y., Quintero J., Anand E., Casillas M., Upadhyaya H. P. (2014. b). Underdiagnosis of attention-deficit/hyperactivity disorder in adult patients: A review of the literature. The Primary Care Companion for CNS Disorders, 16(3), PCC.13r01600.
    1. Israel Ministry of Health. (2020. a, January 24). Coronavirus: Avoid non-essential travel to Wuhan, China (press release). (accessed 8 May 2020).
    1. Israel Ministry of Health. (2020. b, March 10). New Coronavirus guidance. (accessed 8 May 2020).
    1. Lai S., Ruktanonchai N. W., Zhou L., Prosper O., Luo W., Floyd J. R., Wesolowski A., Santillana M., Zhang C., Du X., Yu H., Tatem A. J. (2020). Effect of non-pharmaceutical interventions to contain COVID-19 in China. Nature. Advance online publication. 10.1038/s41586-020-2293-x
    1. Lauer S. A., Grantz K. H., Bi Q., Jones F. K., Zheng Q., Meredith H. R., Azman A. S., Reich N. G., Lessler J. (2020). The incubation period of coronavirus disease 2019 (COVID-19) from publicly reported confirmed cases: Estimation and application. Annals of Internal Medicine, 172(9), 577–582. 10.7326/M20-0504
    1. Li H., Liu S. M., Yu X. H., Tang S. L., Tang C. K. (2020). Coronavirus disease 2019 (COVID-19): Current status and future perspective. International Journal of Antimicrobial Agents, 55(5), 105951.
    1. Lin C., Braund W. E., Auerbach J., Chou J. H., Teng J. H., Tu P., Mullen J. (2020). Policy decisions and use of information technology to fight 2019 novel coronavirus disease, Taiwan. Emerging Infectious Diseases, 26(7), 1506-1512.
    1. Lu X., Zhang L., Du H., Zhang J., Li Y. Y., Qu J., Zhang W., Wang Y., Bao S., Li Y., Wu C., Liu H., Liu D., Shao J., Peng X., Yang Y., Liu Z., Xiang Y., Zhang F., , . . . Wong G. W. K. (2020). SARS-CoV-2 infection in children. New England Journal of Medicine, 382(17), 1663–1665.
    1. Pringle M., Ward P., Chilvers C. (1995). Assessment of the completeness and accuracy of computer medical records in four practices committed to recording data on computer. The British Journal of General Practice: The Journal of the Royal College of General Practitioners, 45(399), 537–541.
    1. Shalev V., Chodick G., Goren I., Silber H., Kokia E., Heymann A. D. (2011). The use of an automated patient registry to manage and monitor cardiovascular conditions and related outcomes in a large health organization. International Journal of Cardiology, 152(3), 345–349.
    1. Shim E., Tariq A., Choi W., Lee Y., Chowell G. (2020). Transmission potential and severity of COVID-19 in South Korea. International Journal of Infectious Diseases, 93, 339–344.
    1. Sohrabi C., Alsafi Z., O’Neill N., Khan M., Kerwan A., Al-Jabir A., Losifidis C., Agha R. (2020). World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19). International Journal of Surgery, 76, 71–76.
    1. Van Doremalen N., Bushmaker T., Morris D. H., Holbrook M. G., Gamble A., Williamson B. N., Williamson B. N., Tamin A., Harcourt J. L., Thornburg N. J., Gerber S. I., Lloyd-Smith J. O., de Wit E., Munster V. J. (2020). Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1. New England Journal of Medicine, 382(16), 1564–1567.
    1. World Health Organization. (2020. a). Coronavirus disease (COVID-19): Situation report, 135. (accessed 4 June 2020).
    1. World Health Organization. (2020. b). Coronavirus disease (COVID-19): Situation report, 12. (accessed 16 April 2020).
    1. World Health Organization. (2020. c). Coronavirus disease (COVID-19) advice for the public. (accessed 8 May 2020).
    1. World Health Organization (2020. d). Global surveillance for human infection with coronavirus disease (COVID-2019). (accessed 4 June 2020).
    1. Wu F., Zhao S., Yu B., Chen Y.-M., Wang W., Song Z.-G., Hu Y., Tao Z.-W., Tian J.-H., Pei Y.-Y., Yuan M.-L., Zhang Y.-L., Dai F.-H., Liu Y., Wang Q.-M., Zheng J.-J., Xu L., Holmes E. C., Zhang Y.-Z. (2020). A new coronavirus associated with human respiratory disease in China. Nature, 579(7798), 265–269.

Source: PubMed

Sponsorit ja yhteistyökumppanit

Sairaudet

Huumeiden interventiot

3
Tilaa