Understanding covid-19 outcomes among people with intellectual disabilities in England

Sosenko, F. et al. (2023) Understanding covid-19 outcomes among people with intellectual disabilities in England. BMC Public Health, 23, 2099. (doi: 10.1186/s12889-023-16993-x) (PMID:37880687) (PMCID:PMC10601171)

Abstract

Background: Evidence from the UK from the early stages of the covid-19 pandemic showed that people with Intellectual Disabilities (ID) had higher rates of covid-19 mortality than people without ID. However, estimates of the magnitude of risk vary widely; different studies used different time periods; and only early stages of the pandemic have been analysed. Existing analyses of risk factors have also been limited. The objective of this study was to investigate covid-19 mortality rates, hospitalisation rates, and risk factors in people with ID in England up to the end of 2021. Methods: Retrospective cohort study of all people with a laboratory-confirmed SARS-CoV-2 infection or death involving covid-19. Datasets covering primary care, secondary care, covid-19 tests and vaccinations, prescriptions, and deaths were linked at individual level. Results: Covid-19 carries a disproportionately higher risk of death for people with ID, above their already higher risk of dying from other causes, in comparison to those without ID. Around 2,000 people with ID had a death involving covid-19 in England up to the end of 2021; approximately 1 in 180. The covid-19 standardized mortality ratio was 5.6 [95% CI 5.4, 5.9]. People with ID were also more likely to be hospitalised for covid-19 than people without ID. The main determinants of severe covid-19 outcomes (deaths and/or hospitalisations) in both populations were age, multimorbidity and vaccination status. The key factor responsible for the higher risk of severe covid-19 in the ID population was a much higher prevalence of multimorbidity in this population. AstraZeneca vaccine was slightly less effective in preventing severe covid-19 outcomes among people with ID than among people without ID. Conclusions: People with ID should be considered a priority group in future pandemics, such as shielding and vaccinations.

• Item Type: Articles
• Additional Information: This work is carried out with the support of the BHF Data Science Centre led by HDR UK (BHF Grant no. SP/19/3/34678). The British Heart Foundation Data Science Centre (grant No SP/19/3/34678, awarded to Health Data Research (HDR) UK) funded co-development (with NHS England) of the Secure Data Environment service for England, provision of linked datasets, data access, user software licences, computational usage, and data management and wrangling support, with additional contributions from the HDR UK Data and Connectivity component of the UK Government Chief Scientifc Adviser’s National Core Studies programme to coordinate national COVID-19 priority research. Consortium partner organisations funded the time of contributing data analysts, biostatisticians, epidemiologists, and clinicians. The associated costs of accessing data in NHS England’s Secure Data Environment service, for analysts working on this study, were funded by the Data and Connectivity National Core Study, led by Health Data Research UK in partnership with the Ofce for National Statistics, which is funded by UK Research and Innovation (grant ref: MC_PC_20058). The Baily Thomas Charitable Fund funded staf (FS) time on this project.
• Keywords: Covid-19, intellectual disabilities, learning disabilities.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Jani, Dr Bhautesh and Henderson, Mrs Angela and Cairns, Professor Deborah and Melville, Professor Craig and Pell, Professor Jill and Mackay, Professor Daniel and Fleming, Dr Michael and Sosenko, Dr Filip and Nijhof, Miss Dewy
• Authors: Sosenko, F., Mackay, D., Pell, J. P., Hatton, C., Jani, B. D., Cairns, D., Ward, L., Henderson, A., Fleming, M., Nijhof, D., Melville, C., and CVD-COVID-UK/COVID-IMPACT Consortium,
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health
• Journal Name: BMC Public Health
• Publisher: BioMed Central
• ISSN: 1471-2458
• ISSN (Online): 1471-2458
• Copyright Holders: Copyright © 2023 The Author(s)
• First Published: First published in BMC Public Health 23:2099
• Publisher Policy: Reproduced under a Creative Commons license