Non-COVID Respiratory Infections Related Emergency Room Visits Among Autistic Adults in the United States.

Introduction: This is a retrospective study that examines the risk of non-COVID-19 respiratory infection (RI)-related emergency department (ED) visits and hospitalizations among autistic adults. The study compares these findings to non-autistic adults using the 2018 Healthcare Cost and Utilization Project Nationwide Emergency Department Sample.

Methods: The data were analyzed in 2022 using the ICD-10-CM codes to extract 46,996 case records that included an autism diagonosis matched by age and sex (140,997) records that did not include an autism diagnosis in a 1:3 case-control ratio. Respiratory infections were also identified using the ICD-10-CM codes and classified by type. Logistic regression models were conducted for the likelihood of presenting with respiratory infections to the emergency department and subsequent hospitalization. All models were adjusted for covariates.

Results: Autistic adults were more likely to present with any type of respiratory infection at the emergency department (AOR=1.83, CI=1.69-2.42), lower respiratory infections (AOR=1.37, CI=1.09-1.50), and pneumonia (AOR=2.42, CI=1.98-2.47) compared to non-autistic adults.. They were also more likely to be hospitalized from respiratory infection during emergency department visits (AOR=3.87, CI=3.21-4.30), including upper respiratory infections and lower respiratory infections, pneumonia, and bronchitis.

Conclusions: Individuals with autism were more likely to experience emergency department visits and hospitalizations because of respiratory infections than individuals without autism. Amid growing evidence of the disproportionate impact of COVID-19 on the autistic population, the study findings highlight a broader, pre-existing burden of respiratory infections among adults with autism in the U.S. that extend beyond the recent pandemic.