Study: ADHD Associated with More Severe COVID-19 Symptoms, Hospital Referrals
ADHD was associated with increased severity of COVID-19 symptoms and more frequent hospital referrals in a recent study of Israeli individuals with ADHD who had contracted the coronavirus.
April 5, 2021
ADHD is associated with increased severity of COVID-19 symptoms and more frequent referral to hospitalization, according to a study published in the Journal of Attention Disorders.1 Severity of COVID-19 infection was defined by “an increased risk of being symptomatic, suffering from greater symptom severity, and being referred to hospitalization after controlling for possible confounding factors, including demographic, medical, psychiatric, and lifestyle variables.”
The study included 1,870 COVID-19 patients, aged 5 to 60 years, 231 of whom had attention deficit hyperactivity disorder (ADHD or ADD). The relationship between ADHD and dependent variables of being symptomatic and being referred to a hospital were evaluated using logistic regression analysis models.
Results replicated previous findings that older age, obesity, and chronic medical conditions increase the risk for COVID-19 severity and hospitalization. In ADHD participants ages 5 to 20, the odds ratio (OR) for being symptomatic was 3.31 compared to non-ADHD participants. A significant association between ADHD and hospital referrals was found in the 21 to 40 age group but disappeared in the 41 to 60 age group, potentially due to the low rates of diagnosed ADHD in older adults. Researchers concluded that age is a significant risk factor for negative outcomes; even though youth may be at a lesser risk, they are not immune to risk.
“We found that that having COVID-19 infection in patients with ADHD was associated with more severe symptoms and an increased rate of referral to hospitalization, even after accounting for variables known to increase the risk for both disorders,” the study said. “It is of note that, in this cohort, ADHD was as strong a predictor for COVID illness as diabetes mellitus and cardiovascular diseases, and much stronger than obesity or asthma. It is suggested that ADHD is by itself a risk factor for severity of COVID-19 illness.”
Though limited by a homogenous sample and underrepresentation of depression, this study and its correlational (not causal) results prompted researchers to hypothesize several explanations for the relationship between ADHD and COVID-19: “ADHD patients may be less likely to practice appropriate self-care, to seek medical attention, or to remain at home. It is also possible that COVID-19 severity is related to the exposed viral load, and that ADHD patients put themselves in high-risk situations, as well as being inattentive and impulsive, which might explain the elevated probability of exposure that expose them to a higher viral load, thus to suffer from more symptoms and having higher risk to be referred to hospitalization.”
Regardless of the causes, these findings should contribute to clinicians’ increased vigilance in caring for patients with ADHD who are COVID-19 positive.
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1 Merzon E, Weiss MD, Cortese S, et al. The Association between ADHD and the Severity of COVID-19 Infection. Journal of Attention Disorders. April 2021. doi:10.1177/10870547211003659