ADHD, Infections, and the Immune System

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CONFERENCE REPORTER

Researchers from the Geha Mental Health Center, Mount Sinai, and Cambridge Health Alliance presented on the connections between attention-deficit/hyperactivity disorder (ADHD) and childhood infectious diseases—as well as COVID-19—at the recent 2022 American Professional Society of ADHD and Related Disorders (APSARD) virtual conference.

Beth Krone, PhD, assistant professor of psychiatry at Mount Sinai’s Icahn School of Medicine, discussed ADHD’s relationship to innate and adaptive immunity among children and adolescents with ADHD. She summarized the key markers and processes of the immune system and the gene proxies that demonstrate how the immune system and the nervous system regulate one another, as well as relevant epidemiological literature and studies of health and diseases among individuals with ADHD.¹

Manor also discussed a population-based case-control study in which she and her colleagues examined the rates of infectious disease in children and adolescents with ADHD compared to a non-ADHD control group with similar demographics. They consulted the electronic medical records of 18,756 patients with ADHD and 37,512 controls without ADHD, all aged 5 to 18, with attention to the exposure categories pediatric ID, anti-infective medications, and number of physicians’ visits. Results showed that the rates for all 3 exposure categories were significantly higher in the patients with ADHD than in the control group. According to Manor, this means children and adolescents with ADHD experience higher occurrences of childhood infectious diseases, receive more prescriptions for anti-infective medications, and have more visits with physicians and other medical experts, suggesting a clear connection between ADHD and childhood infectious diseases.¹

Manor described this connection as a major public health issue, especially during the COVID-19 pandemic, stating that the physicians who treat this patient population should keep in mind the vulnerability of these patients to infectious diseases. She also suggested that ADHD should be considered as a comorbidity in children and adolescents with ADHD who also suffer from multiple or frequent infectious diseases.¹

Margaret D. Weiss, MD, PhD, FRCP(C), medical director of inpatient psychiatry at Cambridge Health Alliance, discussed the connection between ADHD and risk of contracting COVID-19. She stated that ADHD is a specific risk factor for acquiring—and for being hospitalized with—COVID-19 in part because COVID-19 safety guidelines may be difficult for individuals with ADHD to follow, as these individuals may exhibit poor attention, hyperactivity, poor sense of social space, inability to follow instructions, and opposition to rules or mandates. She shared a few important take-home notes: Long COVID may have symptoms similar to those of ADHD and may exacerbate ADHD symptoms; Long COVID may lead to ADHD as a neurological syndrome like encephalitis after Spanish flu; and individuals with ADHD may also be more susceptible to experiencing somatic symptoms of COVID-19. According to Weiss, all these risks may be mitigated in part by effectively treating ADHD.¹

Reference

1. Manor I, Krone B, Weiss M. ADHD, infections, and the immune system. Presented at 2022 APSARD Conference. January 14, 2022.