COVID-19 deaths in people with intellectual disability in the UK and Ireland: descriptive study

Abstract

Background Rapid spread of coronavirus disease 2019 (COVID-19) has affected people with intellectual disability disproportionately. Existing data does not provide enough information to understand factors associated with increased deaths in those with intellectual disability. Establishing who is at high risk is important in developing prevention strategies, given risk factors or comorbidities in people with intellectual disability may be different to those in the general population. Aims To identify comorbidities, demographic and clinical factors of those individuals with intellectual disability who have died from COVID-19. Method An observational descriptive case series looking at deaths because of COVID-19 in people with intellectual disability was conducted. Along with established risk factors observed in the general population, possible specific risk factors and comorbidities in people with intellectual disability for deaths related to COVID-19 were examined. Comparisons between mild and moderate-to-profound intellectual disability subcohorts were undertaken. Results Data on 66 deaths in individuals with intellectual disability were analysed. This group was younger (mean age 64 years) compared with the age of death in the general population because of COVID-19. High rates of moderate-to-profound intellectual disability (n = 43), epilepsy (n = 29), mental illness (n = 29), dysphagia (n = 23), Down syndrome (n = 20) and dementia (n = 15) were observed. Conclusions This is the first study exploring associations between possible risk factors and comorbidities found in COVID-19 deaths in people with intellectual disability. Our data provides insight into possible factors for deaths in people with intellectual disability. Some of the factors varied between the mild and moderate-to-profound intellectual disability groups. This highlights an urgent need for further systemic inquiry and study of the possible cumulative impact of these factors and comorbidities given the possibility of COVID-19 resurgence.

A novel multi-omics-based identification of symptoms, comorbid conditions, and possible long-term complications in COVID-19

“…According to rank (with a cut off score 4), the enriched known or reported comorbid conditions or long-term complications are lupus erythematosus (Rank-1) [100], depressive disorder / mental depression (Rank-2) [30, 101], hepatitis C (Rank-3) [102], breast cancer (Rank-4) [75], arthritis (Rank-5) [103], asthma (Rank-6) [10, 77], liver cancer (Rank-6) [78], tuberculosis (Rank-7) [104, 105], diabetes (Rank-8) [82], myocardial infarction (Rank-9) [35, 106], macular degeneration (Rank-9) [80], chronic kidney disease (Rank-9) [56, 57], arteriosclerosis (Rank-10) [107], ulcerative colitis (Rank-10) [108], liver cirrhosis (Rank-11) [12, 109], sepsis / septicaemia /septic shock (Rank-11) [60, 81], other autoimmune diseases (Rank-12) [49, 50], cerebrovascular accident / stroke (Rank-13) [110], congenital anemia (Rank-13) [111], COPD (Rank-13) [86], multiple myeloma (Rank-14) [112], hypertensive disease (Rank-14) [9, 113], dyslipidemia (Rank-15) [93], metabolic syndrome X (Rank-15) [51, 114], osteoporosis (Rank-16) [91], prostate cancer (Rank-17) [115], psoriasis (Rank-17) [116], leukemia (Rank-18) [117, 118], long QT syndrome (Rank-18) [119], dementia (Rank-18) [120], schizophrenia (Rank-18) [121], intellectual disability (Rank-18) [122, 123], diabetic kidney disease/ diabetic nephropathy (Rank-18) [124]etc.…”

OpenSAFELY: Risks of COVID-19 hospital admission and death for people with learning disabilities - a cohort study

“…Higher mortality rate among people with learning disability has also been demonstrated in Wales 6 , New York State 7 , and the USA more broadly 3 . Not only are death rates higher for people with learning disability, but deaths occur at younger ages 3,8,9,22 . Indeed, the particularly elevated mortality rates among younger people with learning disability noted in our study have also been reported in the USA 3 .…”

“…There is also lack of clarity on the elevated risk of COVID-19 deaths among individuals with milder learning disability, and this needs exploration. 9 The higher risks of premature death among people with learning disability in England is wellknown, 1,10 and triggered the establishment of GP Learning Disability registers to allow for better provision of their healthcare. There are a number of mechanisms by which their risk of COVID-19 mortality may also be greater.…”

“…There is also lack of clarity on the elevated risk of COVID-19 deaths among individuals with milder learning disability, and this needs exploration. 9…”

Risk of adverse outcome of COVID-19 among patients in secure psychiatric services: observational cohort study

“…4,[12][13][14] Higher death rates from COVID-19 have been shown among groups with intellectual disability, possibly because people with intellectual disability having higher rates of medical conditions such as epilepsy, dysphagia and pneumonia. 15 Individuals from Black and minority ethnic backgrounds are more likely to have a poorer outcome in the event of infection. 16 Case fatality rates in individuals over 70 years of age range from 5 to 30%.…”