Hospitalisation and mortality among privately insured individuals with COVID-19 in the United States: The role of intellectual disabilities and Neurogenetic disorders

IF 2.1 2区 医学 Q1 EDUCATION, SPECIAL
A. Davis, N. Copeland-Linder, K. Phuong, H. Belcher, K. van Eck
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引用次数: 0

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.

美国私人投保的 COVID-19 患者的住院率和死亡率:智力残疾和神经遗传疾病的作用。
背景:智障(IDs)和神经遗传病(IDNDs)患者合并症的风险更大,当他们感染2019年冠状病毒病(COVID-19)时,可能会增加该人群的不良后果。本研究的目的是在控制社会人口统计学和合并症的前提下,研究患有和不患有COVID-19的私人投保人的住院和死亡几率:这是一项回顾性横断面研究,研究对象是2020年2月至2020年9月期间被诊断出患有COVID-19的752 237名身份不明的美国私人保险患者中的1174名患有IDs和神经遗传病的患者。分析了COVID-19患者中IDNDs患者的住院和死亡几率,并对人口特征、卫生资源和服务管理局地区、实施平价医疗法案的州以及合并症数量进行了调整:与无 IDNDs 患者相比,IDNDs 患者的 COVID-19 住院率总体更高(35.01% 对 12.65%,P 结论:IDNDs 患者的 COVID-19 住院率总体更高(35.01% 对 12.65%,P 结论):在对社会人口统计学因素进行调整后,IDNDs患者的住院率和死亡率明显更高。在对社会人口统计学和合并症进行调整后,结果仍很明显,但略有下降。对合并症计数进行调整后,住院和死亡几率均呈剂量反应上升,这说明了健康问题对 COVID-19 结果的累积效应。总之,研究结果突出表明,IDNDs患者容易受到COVID-19负面健康结果的影响,这对获得全面的医疗保健服务具有重要意义。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
5.60
自引率
5.60%
发文量
81
期刊介绍: The Journal of Intellectual Disability Research is devoted exclusively to the scientific study of intellectual disability and publishes papers reporting original observations in this field. The subject matter is broad and includes, but is not restricted to, findings from biological, educational, genetic, medical, psychiatric, psychological and sociological studies, and ethical, philosophical, and legal contributions that increase knowledge on the treatment and prevention of intellectual disability and of associated impairments and disabilities, and/or inform public policy and practice. Expert reviews on themes in which recent research has produced notable advances will be included. Such reviews will normally be by invitation.
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