COVID-19 infection and outcomes in a population-based cohort of 17 203 adults with intellectual disabilities compared with the general population

Henderson, A. , Fleming, M. , Cooper, S.-A. , Pell, J. P. , Melville, C. , Mackay, D. F. , Hatton, C. and Kinnear, D. (2022) COVID-19 infection and outcomes in a population-based cohort of 17 203 adults with intellectual disabilities compared with the general population. Journal of Epidemiology and Community Health, 76, pp. 550-555. (doi: 10.1136/jech-2021-218192) (PMID:35232778) (PMCID:PMC8914402)

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Abstract

Background: Adults with intellectual disabilities (ID) may be at higher risk of COVID-19 death. We compared COVID-19 infection, severe infection, mortality, case fatality and excess deaths, among adults with, and without, ID. Methods: Adults with ID in Scotland’s Census, 2011, and a 5% sample of other adults, were linked to COVID-19 test results, hospitalisation data and deaths (24 January 2020–15 August 2020). We report crude rates of COVID-19 infection, severe infection (hospitalisation/death), mortality, case fatality; age-standardised, sex-standardised and deprivation-standardised severe infection and mortality ratios; and annual all-cause mortality for 2020 and 2015–2019. Findings: Successful linkage of 94.9% provided data on 17 203 adults with, and 188 634 without, ID. Adults with ID had more infection (905/100 000 vs 521/100 000); severe infection (538/100 000 vs 242/100 000); mortality (258/100 000 vs 116/100 000) and case fatality (30% vs 24%). Poorer outcomes remained after standardisation: standardised severe infection ratio 2.61 (95% CI 1.81 to 3.40) and mortality ratio 3.26 (95% CI 2.19 to 4.32). These were higher at ages 55–64: 7.39 (95% CI 3.88 to 10.91) and 19.05 (95% CI 9.07 to 29.02), respectively, and in men, and less deprived neighbourhoods. All-cause mortality was slightly higher in 2020 than 2015–2019 for people with ID: standardised mortality ratio 2.50 (95% CI 2.18 to 2.82) and 2.39 (95% CI 2.28 to 2.51), respectively. Conclusion: Adults with ID had more COVID-19 infections, and worse outcomes once infected, particularly adults under 65 years. Non-pharmaceutical interventions directed at formal and informal carers are essential to reduce transmission. All adults with ID should be prioritised for vaccination and boosters regardless of age.

Item Type:Articles
Additional Information:This study was funded by Scottish Government via the Scottish Learning Disabilities Observatory.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Cooper, Professor Sally-Ann and Mackay, Professor Daniel and Hatton, Professor Christopher and Kinnear, Dr Deborah and Melville, Professor Craig and Pell, Professor Jill and Fleming, Dr Michael and Henderson, Mrs Angela
Authors: Henderson, A., Fleming, M., Cooper, S.-A., Pell, J. P., Melville, C., Mackay, D. F., Hatton, C., and Kinnear, D.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > General Practice and Primary Care
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Mental Health and Wellbeing
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Public Health
Journal Name:Journal of Epidemiology and Community Health
Publisher:BMJ Publishing Group
ISSN:0143-005X
ISSN (Online):1470-2738
Published Online:01 March 2022
Copyright Holders:Copyright © 2022 The Authors
First Published:First published in Journal of Epidemiology and Community Health 76:550-555
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher

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