SIB# 474- Intellectual Disability and Covid-19

The Study: The Devastating Impact of Covid-19 on Individuals with Intellectual Disabilities in the United States. 

Overview: A cross-sectional study of 64,858,460 patients reveals that having an intellectual disability was second only to age as the strongest independent risk factor for Covid-19 mortality.

 Key Points: 

·         Individuals with intellectual disabilities have poor health outcomes 

·         Life expectancy for this population and those with developmental disabilities is nearly 20 years below that of the general population 

·         Covid mortality of those with intellectual disabilities and developmental disabilities was nearly 8 times higher than the general population, 

·         Patients with intellectual disabilities also had higher rates of all comorbidities ( other than cancer) prior to Covid-19.  

·         Outcomes for this population may also be complicated by the fact that intellectually disabled patients were “more likely to have a health care payer status associated with low socioeconomic status.” 

·         “The risks to patients with intellectual disabilities incorporate not only risks associated with intellectual disability itself, but also the risks associated with these comorbidities that were overrepresented among those with intellectual disabilities.” 

·         Beyond the direct risk of Covid-19, the pandemic has also impacted the ability of individuals with intellectual disabilities to receive their routine levels of health care and daily support. 

Author’s Conclusions: In this study, having an intellectual disability was the strongest independent risk factor for presenting with a Covid-19 diagnosis and the strongest independent risk factor other than age for Covid-19 mortality.

 Reviewer's Comments: Those with intellectual disabilities and a diagnosis of Covid-19 had higher rates of ICU stay but interestingly did not have higher rates of ICU admission which seems to beg the question of whether or not intellectually disabled patients are less likely to obtain needed hospitalization and higher levels of care they need. 

As the parent of an intellectually disabled child I am acutely aware of my child’s unique risk factors and this study was of particular interest to me. In fact, it should be of interest to every practitioner as we seek to better understand risk profiles for our patients. I apologize that it took me so long to come across this article.

Reviewer:  Mark R. Payne DC  

Reference: Jonathan Gleason MD, Wendy Ross MD, Alexander Fossi MPHc, Heather Blonsky MAS, Jane Tobias DNP, RN, MSN, CPNP-PC, and Mary Stephens, MD. The Devastating Impact of Covid-19 on Individuals with Intellectual Disabilities in the United States.  New England J. Medicine Catalyst. March 5, 2021  

Link To Full Text: https://catalyst.nejm.org/doi/full/10.1056/CAT.21.0051