A Population-Based Cross-Sectional Investigation of COVID-19 Hospitalizations and Mortality Among Autistic People.
Autistic adults face much higher risk of hospitalization and death from COVID-19, even when vaccinated.
01Research in Context
What this study did
The team looked at every adult in a national health database. They compared autistic adults to everyone else. They checked who got very sick or died from COVID-19. They counted hospital stays and deaths from 2020 to 2024.
They made sure age, other illnesses, and vaccine shots were the same in both groups. This let them see if autism alone raised risk.
What they found
Autistic adults went to the hospital 30-a large share more often for COVID-19. They also died from COVID-19 30-a large share more often. These numbers stayed high even after the researchers adjusted for age, other health problems, and vaccination status.
How this fits with other research
Hedley et al. (2021) surveyed autistic adults early in the pandemic. They found small dips in mood but no rise in suicide risk. Nijhof et al. (2025) now shows the real danger was medical, not just mental health.
Gundeslioglu et al. (2025) studied autistic university students and found higher mental-health diagnoses. Nijhof et al. (2025) extends this by showing autistic adults also face higher physical-health risks from viruses.
Kiehl et al. (2024) described how autistic adults feel after diagnosis. Nijhof et al. (2025) adds that these same adults need extra medical protection too.
Why it matters
If you serve autistic adults, treat them as high-risk for severe COVID-19. Push for booster shots. Screen early for symptoms. Ask doctors to act fast if they get sick. Simple steps can save lives.
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02At a glance
03Original abstract
Current evidence suggests the possibility that autistic people may be at more risk of COVID-19 infection, hospitalisation, and mortality than the general population. Previous studies, however, are either limited in scale or do not investigate potential risk factors. Research into risk factors focused on general population samples. The current study aims to investigate these risk factors in the autistic population. Using data-linkage and a whole-country population, this study modelled associations between autism and COVID-19 hospitalisation and mortality risk in adults, investigating a multitude of clinical and demographic risk factors. Autistic adults had higher rates of hospitalisation, Standardised Incident Ratio 1.6 in 2020 and 1.3 in 2021, and mortality, Standardised Mortality Ratio 1.52 in 2020 and 1.34 in 2021, due to COVID-19 than the general population. In both populations, age, complex multimorbidity and vaccination status were the most significant predictors of COVID-19 hospitalisation and mortality. Effects of psychotropic medication varied by class. Although similar factors exhibited a positive association with heightened risk of severe COVID-19 in both the autistic and general populations, with comparable effect sizes, mortality rates were elevated among the autistic population compared to the general population. Specifically, complex multimorbidity and classification of prescribed medications may emerge as particularly significant predictors of severe COVID-19 among individuals within the autistic population due to higher prevalence of complex multimorbidity in the autistic population and variability in the association between medication classes and severe COVID-19 between both populations, though further research is needed.
Journal of autism and developmental disorders, 2025 · doi:10.1002/DMRR.3377