Abstract

Abstract
Objectives To compare COVID-19 infection, severe infection, mortality, case-fatality, and excess deaths, among adults with intellectual disabilities and those without.

Design Record-linkage of all adults recorded with intellectual disabilities in Scotland’s Census, 2011, and a 5% sample of other adults, to COVID-19 test results (Electronic Communication of Surveillance in Scotland), hospitalisations (Scottish Morbidity Record 01), and deaths (National Records of Scotland).

Setting General population; 24th January 2020 - 15th August 2020

Participants Successful linkage of 94.8% provided data on 17,173 adults with, and 195,859 without, intellectual disabilities.

Outcomes Crude rates of COVID-19 infection, severe infection (hospitalisation/death), mortality, and case fatality; age-, sex- and deprivation-standardised severe infection and mortality ratios; annual all-cause mortality for 2020 and 2015-2019.

Results Adults with intellectual disabilities had higher rates of COVID-19 infection (957/100,000 versus 513/100,000); severe infection (549/100,000 versus 237/100,000); mortality (259/100,000 versus 114/100,000); and case-fatality (30% versus 24%). Poorer COVID-19 outcomes remained after standardising for age, sex and deprivation: standardised severe infection ratio 2.59 (95% CI 1.80, 3.39) and mortality ratio 3.20 (95% CI 2.16, 4.25). These were higher among 55-64 year olds: 7.12 (95% CI 3.73, 10.50) and 16.16 (95% CI7.69, 24.63) respectively. Among adults with intellectual disabilities, all-cause mortality was only slightly higher in 2020 than the previous five years: standardised mortality ratios 2.49 (95% CI 2.17, 2.81) and 2.38 (95% CI 2.26, 2.49) respectively.

Conclusions Adults with intellectual disabilities were more likely to be infected with COVID-19, and had worse outcomes once infected, particularly those under 65 years. Non-pharmaceutical interventions directed at formal and informal carers are essential to reduce transmission and all adults with intellectual disabilities should be immediately prioritised for vaccination regardless of age.

Rights

Made available under a CC-BY-NC 4.0 International license (http://creativecommons.org/licenses/by-nc/4.0/).

Cite as

Henderson, Angela, Fleming, M., Cooper, S., Pell, J., Melville, C., Mackay, D., Hatton, C. & Kinnear, D. 2021, 'COVID-19 infection and outcomes in a population-based cohort of 17,173 adults with intellectual disabilities compared with the general population'Available at: https://doi.org/10.1101/2021.02.08.21250525

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Last updated: 28 October 2023
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