Causal associations between COVID-19 and childhood mental disorders

BMC Psychiatry. 2023 Dec 8;23(1):922. doi: 10.1186/s12888-023-05433-0.

Abstract

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can invade both the peripheral and central nervous systems and impact the function of the brain. Therefore, it is necessary to evaluate the mutual influences between COVID-19 outcomes and childhood mental disorders.

Methods: We examined genetic correlations and potential causalities between three childhood mental disorders and three COVID-19 phenotypes by genetically proxied analyses. The three mental disorders included attention-deficit/hyperactivity disorder (ADHD, N = 292,548), Tourette's syndrome (TS, N = 14,307), and autism spectrum disorder (ASD, N = 46,350). The three COVID-19 traits included SARS-CoV-2 infection (N = 2,597,856), hospitalized COVID-19 (N = 2,095,324), and critical COVID-19 (N = 1,086,211). Literature-based analysis was used to build gene-based pathways connecting ADHD and COVID-19.

Results: ADHD was positively correlated with the three COVID-19 outcomes (Rg: 0.22 ~ 0.30). Our Mendelian randomization (MR) analyses found that ADHD confers a causal effect on hospitalized COVID-19 (odds ratio (OR): 1.36, 95% confidence interval (CI): 1.10-1.69). TS confers a causal effect on critical COVID-19 (OR: 1.14, 95% CI: 1.04-1.25). Genetic liability to the COVID-19 outcomes may not increase the risk for the childhood mental disorders. Pathway analysis identified several immunity-related genes that may link ADHD to COVID-19, including CRP, OXT, IL6, PON1, AR, TNFSF12, and IL10.

Conclusions: Our study suggests that both ADHD and TS may augment the severity of COVID-19 through immunity-related pathways. However, our results did not support a causal role of COVID-19 in the risk for the childhood mental disorders.

Keywords: Attention-deficit/hyperactivity disorder; Autism spectrum disorder; COVID-19; Mendelian randomization; Tourette’s syndrome.

MeSH terms

  • Aryldialkylphosphatase
  • Attention Deficit Disorder with Hyperactivity* / complications
  • Autism Spectrum Disorder* / complications
  • Autism Spectrum Disorder* / genetics
  • COVID-19*
  • Causality
  • Child
  • Genome-Wide Association Study
  • Humans
  • SARS-CoV-2

Substances

  • PON1 protein, human
  • Aryldialkylphosphatase