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Those with IDD more likely to die from COVID-19, says SUNY Upstate, SU study

A new study published recently in ScienceDirect by researchers from SUNY Upstate Medical University and Syracuse University and shows that people with intellectual and developmental disabilities (IDD) are more likely to die from COVID-19 than those without IDD.

According to the researchers, the disparity is likely related to a higher prevalence of comorbid diseases among those with IDD, and/or a higher percentage of people with IDD are living in congregate residential settings.

Their study, “Intellectual and Developmental Disability and COVID-19 Case-Fatality Trends: TriNetX Analysis,” was published by ScienceDirect's Disability and Health Journal. The study included 30,282 people who were identified as COVID-19 positive in the TriNetX COVID-19 Research Network Platform.

“This is the earliest published study with empirical evidence showing death rates are higher for people with than without IDD at ages 0-17 and 18-74, but with similar rates at ages 75 and older,” said Upstate Distinguished Service Professor Margaret Turk, MD, who holds academic appointments in physical medicine and rehabilitation, pediatrics and public health and preventive medicine. “These age difference trends in death rates were noted in people with IDD who demonstrated overall higher rates of health conditions considered a risk for severe outcomes with COVID-19 at all ages.”

Turk continued, “Our study highlights the age effect within a population who often die at younger ages and the presence of multiple health conditions across all ages as risk factors for poor outcomes—and merits further investigation of COVID-19 outcomes in this and other disability groups.”

“More attention is needed to this vulnerable health population in order to ensure their safety and well-being during this pandemic, including careful attention to the impact of public policies such as PPE prioritization and funding streams on the ability of residential service providers to guarantee quality care during this time," said Scott Landes, PhD, an associate professor of sociology at Syracuse University's Maxwell School of Citizenship and Public Affairs and a research affiliate for the Lerner Center for Public Health Promotion.

Invaluable to the researchers was the amount of information immediately available to quantify the pandemic’s risk to this population. 

“Access to robust national and international electronic medical record data on the TriNetX platform provided us with a rare opportunity to quickly assess the impact of a novel virus in a population that is often overlooked,” said Margaret Formica, PhD., Upstate associate professor of public health and preventive medicine, and urology.

The study was conducted by a trio form Upstate—Turk, Formica and Katherine Goss, MPH, of the Disability & Health Research Team—and Landes. Here is a more detailed look at their findings:

Every individual in this study had COVID-19, so rates are case-fatality rates that gave the researchers an idea of the severity of the disease among both groups. Among ages 0-17, for every 100 individuals with COVID-19, 1.6 with IDD died and less than one without IDD died. Among ages 18-74, for every 100 individuals with COVID-19, 4.5 with IDD died compared to 2.7 without IDD. Rates were similar for those 75 and over—for every 100 individuals with COVID-19, 21.1 with IDD died and 20.7 without IDD died.

“Based upon the case fatality rates we report among those ages 18-74, if 100,000 individuals with IDD contract COVID-19 - which is entirely possible in light of the estimates of the size of this population and the cumulative incidence rates we are seeing in our research—we would expect 4,500 to die,” Landes said. “Comparatively, among 100,000 individuals without IDD, we would expect 2,700 to die. That would be an excess of 1,800 IDD deaths and in my mind that is unacceptable.”

The researchers also found that individuals with IDD had a higher prevalence of comorbid circulatory, respiratory, and endocrine diseases across all age groups. While they could not test causality in this data, it is possible this partly explains the differences they found in case-fatality rates. Some of this difference may also be due to the higher percentage of individuals with IDD who reside in congregate settings—a characteristic the researchers could not account for in the study but are continuing to investigate.