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By Jason Gale | Bloomberg As COVID swept across California in early 2020, pediatric infectious diseases physician Karin Nielsen grew alarmed by the crisis erupting in maternity wards. Pregnant women were placed on life support, undergoing emergency C-sections as the virus triggered severe complications. Some died. Nielsen had just finished a research project on how the emerging infectious disease Zika was causing severe birth defects. Concerned the new coronavirus might have a similar impact, she began recruiting expectant mothers who tested positive for a new study. Soon after the study’s participants began giving birth, Nielsen’s colleagues at UCLA’s Mattel Children’s Hospital noticed an unusual number of their newborns requiring intensive care. Nielsen recalls another doctor stopping her to ask, “What’s wrong with the babies in your study?” NEXT PANDEMIC? How America lost control of the bird flu Sure enough, when researchers analyzed videos of the children lying on their backs in what’s called the General Movement Assessment, 14% of the infants showed signs of developmental problems. The test evaluates early motor functions and is often used to assess the risk of neurodevelopmental disorders including cerebral palsy. Later, during in-clinic assessments, the findings proved equally troubling. At 6-8 months old, 13 of 109 infants born to infected mothers — almost 12% — had failed to reach developmental milestones. In stark contrast, all infants in a control group born before the pandemic showed normal development. As additional participants from LA and Rio were enrolled, more unsettling results emerged. Around 11.6% of toddlers born to mothers with lab-confirmed SARS-CoV-2 infection during pregnancy showed cognitive, motor, or language problems indicative of neurodevelopmental delays. By comparison, only two of 128 unexposed controls — 1.6% — showed such issues. When the eldest of the Covid-exposed babies reached 28 months, the study found another concerning pattern: 23 of 211 children — almost 11% — screened positive for autism spectrum disorder. The finding, presented in May at a medical conference in Copenhagen, compared with an expected prevalence of 1-2% at that age, when some children begin showing signs of the condition. Around one in 36 or under 3% of children are eventually diagnosed with autism, according to the Centers for Disease Control and Prevention. “There’s something really going on,” Nielsen says. “We don’t want to alarm the world, but that’s what our data are showing.” The later findings, currently undergoing peer review ahead of publication, are a reminder that Covid’s long-term consequences, including higher risks for dementia and heart disease, continue to unravel almost five years after the pandemic began. While the virus is generally known to cause more severe symptoms in adults than in children, emerging research suggests that babies exposed to Covid in utero face elevated risks for preterm birth, congenital heart abnormalities and rare conditions, such as organs developing on the opposite side of the body. Greater odds of autism from in utero exposure to Covid would add another piece to the puzzle. The connection between the virus and autism remains inconclusive: some studies align with Nielsen’s findings, while others report little to no increased risk of developmental or behavioral issues. A limitation of Nielsen’s study is its relatively small sample size, with fewer than 250 mother-baby pairs. A robust understanding of the virus’ impact would likely require research involving more than 10,000 children, says Andrea Edlow, a maternal-fetal medicine specialist at Boston’s Massachusetts General Hospital. Such large-scale research has been difficult, particularly during the most deadly waves of the pandemic when clinic restrictions and medical emergencies obstructed consistent testing. Nielsen herself is wary of raising unnecessary fears. Autism remains something of a mystery, with its exact triggers still unclear. Scientists suspect an intersection of genetic and environmental factors, but the condition comes in many forms: some children have intellectual disabilities, while others don’t but still struggle with significant behavioral problems, complicating diagnoses. Many individuals with autism also experience co-occurring health issues such as attention-deficit/hyperactivity disorder, seizures, or chronic gastrointestinal problems. In much of the world, an awareness of autism is only starting to catch on. Global autism prevalence was estimated at 1 in 127 as of 2021 in a study published last week, more than double the 1-in-271 ratio reported in 2019, and researchers say this is likely driven by increased awareness and better diagnostic practices. The lack of clear explanations has provided fertile ground for myths, including the debunked belief that vaccines cause autism.Still, scientists say Nielsen’s study warrants serious attention due to the consistency of its findings. It also stands out for its rigor: trained physicians used standardized assessment tools at multiple points in time to evaluate developmental progress rather than relying on electronic health records or parent-completed questionnaires. Children born during the Covid era are now reaching the average age for autism diagnoses. Identifying developmental issues early can open the door to speech and behavioral therapies, which are proven to support a child’s development. This makes it a critical moment to study the pandemic’s impact. Nielsen, born to a Danish father and Brazilian mother in Rio de Janeiro, where she attended medical school, has dedicated much of her career to studying how maternal infections, such as HIV and Zika, affect child health. The mosquito-borne Zika virus is known for causing cerebral palsy and microcephaly, a severe congenital brain malformation that often leads to profound intellectual and developmental disabilities. Other maternal infections such as rubella and certain herpesviruses, particularly during the first trimester, are also known to harm the fetus directly, resulting in issues such as hearing loss, cerebral palsy, and autism. From the pandemic’s onset, Nielsen sensed that Covid, too, would leave its mark. “We saw this as a new pathogen and an opportunity to investigate its impact on these babies,” Nielsen says. She soon saw parallels. In 2021, the WHO confirmed that the coronavirus could cross the placental barrier via the maternal bloodstream, placing it in the same category as viruses like rubella and Zika. Some researchers believe the damage stems from inflammation triggered by the virus or viral components crossing the placenta. But Covid also appeared to affect fetuses in a unique way. One of the earliest signs emerged in early 2021 in County Cork, Ireland, during a surge of the alpha variant. A cluster of stillbirths in the first three months of that year prompted doctors to investigate. They discovered that the placentas linked to the fetal deaths were infected with the coronavirus, describing them as riddled with lesions likely caused by viral transmission through the maternal bloodstream. Similar cases began to surface in the US and at least 10 other countries, prompting David Schwartz, an Atlanta-based epidemiologist and perinatal pathologist, to lead an investigation. The findings were startling: on average, more than three-quarters of the tissue in infected placentas had been damaged, cutting off oxygen and nutrients essential for fetal survival. Alarmingly, this damage could occur silently, even in mothers without acute Covid symptoms, offering no warning signs. “We’ve never seen anything like this with an infectious disease,” said Schwartz, a medical anthropologist and pathologist with 45 years of experience studying placentas affected by pathogens such as HIV, Ebola, yellow fever, and Zika. “So far, I feel very confident in saying this is unique to this virus.” Studies by Schwartz and Nielsen highlighted that vaccination protects mothers against Covid’s obstetric complications, particularly during waves driven by variants more likely to cause severe disease. One possible clue to explaining the higher risks of neurodevelopmental issues seen in Nielsen’s study is that Covid, particularly in unvaccinated mothers, increases the risk of preterm delivery. In the US in 2021, the rate of preterm births rose by 4% to 10.5%, the highest since at least 2007. The likelihood of stillbirths nearly doubled for American mothers with Covid compared to those who avoided infection during the pandemic’s first year and a half. Similarly, a study in England found that mothers infected with SARS-CoV-2 at delivery were more than twice as likely to experience fetal death or preterm birth. Another explanation is that prolonged fevers triggered by illnesses like the flu can impair neural development indirectly by activating the maternal immune system. This creates an inflammatory environment in the uterus that can disrupt fetal brain development. Related Articles Nielsen suspects that maternal immune activation might explain the high rates of neurodevelopmental delays observed among the infants in her study. Among at least four toddlers with severe delays, blood tests taken at birth revealed biomarkers of activated microglia – the brain’s immune cells – attacking neurons. “When you see microglial activation and neuronal signaling pathways traditionally associated with autism showing up in this cohort, it suggests there’s something behind it,” she says. Scientists say the full consequences of in utero exposure to the coronavirus may take decades to uncover and understand. Even if a link is established, genetics are likely to play a crucial role, according to Mady Hornig, a physician-scientist in New York. She is also an investigator on the Autism Birth Cohort project, a collaboration between the Norwegian Institute of Public Health and Columbia University studying the development of the condition for more than 20 years. Understanding the interplay of genetics with immune activity, inflammation, and stress might help unravel why some infants may face developmental challenges, she said. Identifying the various risks “requires additional rigorous study,” Hornig said. If Nielsen’s findings do reflect broader population trends the implications could be profound. “Early neurodevelopmental disturbances have potential implications for disability throughout a lifetime,” she said.Even small increases in risk could substantially add to the global burden of chronic disease, given the sheer number of pregnancies affected. Nielsen continues to analyze stored blood and other specimens from the babies in her study. “It’s a new pathogen. We don’t know how it behaves,” she said. “Things might appear down the road that we were not expecting.”Manchester City's midfield is arguably one of the strongest in the league, with players like Kevin De Bruyne, Ilkay Gundogan, and Rodri providing creativity, control, and defensive solidity in equal measure. Their ability to dictate play, break down opposition defenses, and track back to support the defense has been instrumental in Manchester City's success this season.Lehigh holds off Long Island U late, earn a 60-59 win
And single people are more likely to use mobility tools compared to those who are married, according to researchers from University College London (UCL) and the London School of Hygiene and Tropical Medicine (LSHTM). Researchers looked at information from a group of more than 12,000 adults in England aged 50 to 89 who were tracked over a 13-year period. At the start of the study, 8,225 adults had no mobility difficulty and did not use mobility assistive products (MAPs). Some 2,480 were deemed to have “unmet need” and 1,375 were using mobility aids. During the follow-up period, there were 2,313 “transitions” where people went from having no mobility issues to needing some help with getting around. And 1,274 people started to use mobility aids. Compared with men, women were 49% more likely to transition from not needing mobility aids to needing to use them, according to the study which has been published in The Lancet Public Health. But were 21% less likely to go on to use mobility aids when they needed them. The authors said their study showed “barriers to access” for women. For both men and women, with every year that passed during the study period the need for mobility aids increased. People who were older, less educated, less wealthy or reported being disabled were more likely to “transition from no need to unmet need, and from unmet need to use”, the authors said, with this indicating a “higher prevalence of mobility limitations and MAP need overall among these groups”. They added: “Finally, marital or partnership status was not associated with transitioning to unmet need; however, single people were more likely to transition from unmet need to use compared with married or partnered people.” Jamie Danemayer, first author of the study from UCL Computer Science and UCL’s Global Disability Innovation Hub, said: “Our analysis suggests that there is a clear gender gap in access to mobility aids. “Though our data didn’t ascertain the reason why participants weren’t using mobility aids, other research tells us that women are often more likely than men to face obstacles such as cost barriers as a result of well-documented income disparities between genders. “Many mobility aids are designed for men rather than women, which we think may be a factor. “Using mobility aids can also make a disability visible, which can impact the safety and stigma experienced by women, in particular. “There’s a critical need for further research to identify and break down the barriers preventing women from accessing mobility aids that would improve their quality of life.” Professor Cathy Holloway, also from UCL, added: “Not having access to mobility aids when a person needs one can have a big impact on their independence, well-being and quality of life. “Our analysis suggests that women, in particular, regardless of other factors such as education and employment status, are not getting the support that they need.” Professor Shereen Hussein, senior author of the study and lead of the social care group at the London School of Hygiene & Tropical Medicine, said: “The research provides compelling evidence of gender disparities in accessing assistive technology, suggesting that cost, design bias, and social stigma are likely to disproportionally affect women. “This underscores the need for inclusive, gender-sensitive approaches in the design, production and inclusivity of assistive technologies.”