Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental condition of the central nervous system (CNS) that presents with severe communication problems, impairment of social interactions, and stereotypic behaviours. Emerging studies indicate possible associations between viral infections and neurodegenerative and neurobehavioural conditions including autism. Viral infection during critical periods of early in utero neurodevelopment may lead to increased risk of autism in the offspring. This review is aimed at highlighting the association between viral infections, including viruses similar to COVID-19, and the aetiology of autism. A literature search was conducted using Pubmed, Ovid/Medline, and Google Scholar database. Relevant search terms included “rubella and autism”, “cytomegalovirus and autism”, “influenza virus and autism”, “Zika virus and autism”, “COVID-19 and autism”. Based on the search terms, a total of 141 articles were obtained and studies on infants or children with congenital or perinatal viral infection and autistic behaviour were evaluated. The possible mechanisms by which viral infections could lead to autism include direct teratogenic effects and indirect effects of inflammation or maternal immune activation on the developing brain. Brain imaging studies have shown that the ensuing immune response from these viral infections could lead to disruption of the development of brain regions and structures. Hence, long-term follow up is necessary for infants whose mothers report an inflammatory event due to viral infection at any time during pregnancy to monitor for signs of autism. Research into the role of viral infection in the development of ASD may be one avenue of improving ASD outcomes in the future. Early screening and diagnosis to detect, and maybe even prevent ASD are essential to reduce the burden of this condition.
Highlights
We summarise the growing body of evidence, encompassing human studies and experimental animal studies that supports a possible connection between viral infection and the risk of autism
Namely rubella, cytomegalovirus, influenza virus, Zika virus, and COVID-19 were considered for inclusion owing to their strong association and possible risk to Autism spectrum disorder (ASD)
The following search terms were used in the search process: (1) Rubella and autism, (2) Cytomegalovirus and autism, (3) Influenza virus and autism, (4) Zika virus and autism, and (5) COVID-19 and autism
Summary
Autism spectrum disorder (ASD) is a neurodevelopmental disability characterised by social and communication impairment and by restricted interest, repetitive and stereotyped behaviours [1]. The degree of developmental disabilities among individuals with ASD is variable, but the impacts on affected individuals and their families are life-changing [2]. The earlier studies of autism prevalence published in the 1960s and 1970s reported approximately 4 to 5 cases per 10,000 children [3]. Since the 1990s, a substantial increase in the estimated prevalence of autism in the United State (US) have been reported. ASD is one of the most prevalent neurodevelopmental disorders that affect children today
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