Intellectual disability appears to be second only to older age as a risk factor for dying from COVID-19, new research has found, suggesting need for prioritising this population and their caregivers for vaccination.

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Those with intellectual disabilities were 2.5 times more likely to contract COVID-19, were about 2.7 times more likely to be admitted to the hospital and 5.9 times more likely to die from the infection than the general population, showed the results published in the New England Journal of Medicine (NEJM) Catalyst. "The chances of dying from COVID-19 are higher for those with intellectual disability than they are for people with congestive heart failure, kidney disease or lung disease," said lead author Jonathan Gleason from Thomas Jefferson University Hospital (Jefferson Health) in the US. "That is a profound realisation that we have not, as a healthcare community, fully appreciated until now."

The authors examined 64 million patient records from 547 healthcare organisations between January 2019 to November 2020 to understand the impact of the COVID-19 pandemic on patients with intellectual disabilities. They identified variables such as COVID-19, intellectual disability or other health conditions, as well as demographic factors such as age. "Our failure to protect these deeply vulnerable individuals is heart-breaking," said co-author Wendy Ross, a developmental and behavioural pediatrician at Jefferson Health. "I believe that if we can design a system that is safe and accessible for people with intellectual disabilities, it will benefit all of us."

The authors wrote that patients with intellectual disabilities may have less ability to comply with strategies that reduce the risk of infection, such as masking and social distancing. In addition, the researchers showed that these patients are more likely to have additional health conditions that contribute to a more severe course of COVID-19 disease. The results of the study highlight how these issues become compounded in this population. "We need to understand more about what is happening with these patients," said Gleason. "I do believe these patients and their caregivers should be prioritised for vaccination and healthcare services."