Filip Sosenko, Daniel Mackay, Jill P. Pell, Chris Hatton, Bhautesh D. Jani, Deborah Cairns, Laura Ward, Angela Henderson, Michael Fleming, Dewy Nijhof, Craig Melville, on behalf of the CVD-COVID-UK/COVID-IMPACT Consortium
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. While there is agreement across the studies on a higher risk among people with ID, their estimates of the magnitude of risk vary widely; different studies used different time periods; and only early stages of the pandemic have been analysed. Furthermore, there is very little consistency in how ID was classified across these different analyses. Additionally, different studies reported different mortality measures, making it difficult to compare findings. Last but not least, the modelling of risk factors in existing studies included people who did not have SARS-CoV-2 infection at all.
The aim of this study was to address the limitations of existing studies by accurately ascertaining cases over the main pandemic period. Importantly, the current study also aimed to deepen our understanding of risk factors. Pre-existing long-term conditions (LTCs) have been shown to have strong associations with severe covid-19 in general population studies, and some studies have examined associations between specific LTCs and covid-19 outcomes among people with ID. Similarly, polypharmacy has been found to be a risk factor for severe covid-19 outcome in the general population. However, no studies have examined the effects of multimorbidity and polypharmacy on severe covid-19 among people with ID, who are known to have higher rates of both. Furthermore, no studies have examined the associations between vaccination status, vaccine type, and severe covid-19 in people with ID.
This project aims to address the gaps and limitations in research outlined above. Specifically, the research questions were:
- How does covid-19 mortality and hospitalisations among people with ID compare with that of people without ID?
- Are there significant differences in the associations between clinical risk factors and risk of hospitalisation and death following SARS-CoV-2 infection in people with and without ID?
- Which factors are key drivers of severe covid-19, in both the ID and non-ID populations?
- What factors are responsible for the higher probability of severe covid-19 among people with ID?
Sosenko, F., Mackay, D., Pell, J.P. et al. Understanding covid-19 outcomes among people with intellectual disabilities in England. BMC Public Health 23, 2099 (2023). https://doi.org/10.1186/s12889-023-16993-x
- View the analysis code used in NHS England's SDE for England
- View the phenotyping algorithms and codelists used in NHS England's SDE for England
This is a sub-project of project CCU030 approved by the CVD-COVID-UK / COVID-IMPACT Approvals & Oversight Board (sub-project: CCU030_01).
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