Hospitalisation and mortality among privately insured individuals with COVID-19 in the United States: The role of intellectual disabilities and Neurogenetic disorders.
COVID-19 hits adults with ID or neurogenetic disorders far harder even when other illnesses are ruled out.
01Research in Context
What this study did
McQuaid et al. (2024) looked at private insurance records of adults with intellectual or neurogenetic disorders. They asked: does this group get sicker or die more often from COVID-19 than matched peers?
They counted hospital stays and deaths while holding age, sex, income, and other illnesses steady.
What they found
People with ID or neurogenetic disorders were 1.4 times more likely to be hospitalised and 2.7 times more likely to die from COVID-19. The extra risk stayed even after removing the effect of other health problems.
How this fits with other research
Lemons et al. (2015) first showed that low IQ alone does not raise death risk—schooling matters. McQuaid et al. (2024) now says the virus era is different: ID itself adds danger even with good care.
Nevin et al. (2005) saw higher hospital use among Finnish adults with ID before the pandemic. The new US data echo that pattern, proving the gap widens under COVID-19 stress.
Greenlee et al. (2024) argue we need better ID tracking in health files. McQuaid et al. (2024) prove why: without clear flags, life-saving triage can miss the people who need it most.
Why it matters
Your clients with ID may look stable until they crash. Use this paper to press for fast testing, monoclonal antibodies, and hospital admission at lower symptom thresholds. Add an ID alert to crisis plans and teach families to say “intellectual disability” first in the ER so staff see the risk.
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Add an ID flag to each client’s medical summary sheet and review it with them before any COVID-19 exposure.
02At a glance
03Original abstract
BACKGROUND: Individuals with intellectual disabilities (IDs) and neurogenetic conditions (IDNDs) are at greater risk for comorbidities that may increase adverse outcomes for this population when they have coronavirus disease 2019 (COVID-19). The study aims are to examine the population-level odds of hospitalisation and mortality of privately insured individuals with COVID-19 with and without IDNDs IDs, controlling for sociodemographics and comorbid health conditions. METHODS: This is a retrospective, cross-sectional study of 1174 individuals with IDs and neurogenetic conditions within a population of 752 237 de-identified, privately insured, US patients diagnosed with COVID-19 between February 2020 and September 2020. Odds of hospitalisation and mortality among COVID-19 patients with IDNDs adjusted for demographic characteristics, Health Resources and Services Administration region, states with Affordable Care Act and number of comorbid health conditions were analysed. RESULTS: Patients with IDNDs overall had higher rates of COVID-19 hospitalisation than those without IDNDs (35.01% vs. 12.65%, P < .0001) and had higher rates of COVID-19 mortality than those without IDNDs (4.94% vs. .88%, P < .0001). Adjusting for sociodemographic factors only, the odds of being hospitalised for COVID-19 associated with IDNDs was 4.05 [95% confidence interval (CI) 3.56-4.61]. Adjusting for sociodemographic factors and comorbidity count, the odds of hospitalisation for COVID-19 associated with IDNDs was 1.42 (95% CI 1.25-1.61). The odds of mortality from COVID-19 for individuals with IDNDs adjusted for sociodemographic factors only was 4.65 (95% CI 3.47-6.24). The odds of mortality from COVID-19 for patients with IDNDs adjusted for sociodemographic factors and comorbidity count was 2.70 (95% CI 2.03-3.60). A major finding of the study was that even when considering the different demographic structure and generally higher disease burden of patients with IDNDs, having a IDND was an independent risk factor for increased hospitalisation and mortality compared with patients without IDNDs. CONCLUSIONS: Individuals with IDNDs had significantly higher odds of hospitalisation and mortality after adjusting for sociodemographics. Results remained significant with a slight attenuation after adjusting for sociodemographics and comorbidities. Adjustments for comorbidity count demonstrated a dose-response increase in odds of both hospitalisation and mortality, illustrating the cumulative effect of health concerns on COVID-19 outcomes. Together, findings highlight that individuals with IDNDs experience vulnerability for negative COVID-19 health outcomes with implications for access to comprehensive healthcare.
Journal of intellectual disability research : JIDR, 2024 · doi:10.1111/jir.13116