Patients with intellectual and developmental disabilities (IDD) with SARS-CoV-2 infections may have a higher risk for post-COVID-19 conditions, according to study findings published in the journal BMC Medicine.
Individuals with IDD are more susceptible to contracting severe COVID-19 disease. However, it’s unclear what are the long-term effects of COVID-19 infection among this population. Therefore, researchers assessed the prevalence of post-COVID-19 conditions in patients with IDD and compare their risk with that of the general population.
Researchers conducted a retrospective cohort study of 36,308 patients with data gathered from the TriNetX Research Network. Patients with IDD and without (n=18,154) were included if they visited a health care organization between March 1, 2020 to October 1, 2022 to compare the risk of developing post-COVID-19 conditions. A Kaplan-Meier and log rank test were used to evaluate potential progression and duration of post-COVID-19 conditions in individuals with IDD.
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[T]he vulnerability of the IDD population to both COVID-19 and its post-infection sequelae, possibly due to a confluence of intellectual disability and prevalent comorbidities.
The primary outcome was a composite outcome observed between 90-180 days after index date consisting of 12 post-COVID-19 conditions;
- chest/throat pain,
- abnormal breathing,
- abdominal symptoms,
- fatigue/malaise,
- anxiety/depression,
- headache,
- cognitive dysfunction,
- myalgia,
- loss of taste or smell,
- sleep disturbance,
- cough, and
- palpitations.
Patients were matched based on patient demographics with IDD and without, they were mostly White (67.19%) and had a mean age of 38.9.
Overall, during the 90-to-180-day follow-up, patients with IDD were reported to experience post-COVID-19 conditions more often than patients without (15.82%; 95% CI, 15.22-16.45 vs 13.99%; 95% CI, 13.39-14.61). Between 9- and 180 days, the primary composite outcome for any post-COVID-19 condition was higher in patients with IDD than control (HR, 1.120; 95% CI, 1.053-1.191).
The post-COVID-19 conditions most prevalent in patients with IDD were: anxiety/depression (6.59%; 95% CI, 6.19-7.02),
- abdominal symptoms (5.42%; 95% CI, 5.06-5.82),
- abnormal breathing (4.41%; 95% CI, 4.08-4.77),
- fatigue (3.62%; 95% CI, 3.32-3.95), and
- cough (3.59%; 95% CI, 3.29-3.91).
For patients with IDD, there was an increased risk for:
- abnormal breathing (HR, 1.216; 95% CI, 1.077-1.373),
- abdominal symptoms (HR, 1.259; 95% CI, 1.28-1.406),
- fatigue (HR, 1.397; 95% CI, 1.216-1.606),
- anxiety/depression (HR, 1.257; 95% CI, 1.050-1.274),
- cognitive symptoms (HR, 1.828; 95% CI, 1.529-2.186),
- myalgia (HR, 1.325; 95% CI, 1.077-1.631),
- sleep disturbance (HR, 1.481; 95% CI, 1.148-1.910), and
- cough (HR, 1.315; 95% CI, 1.146-1.508).
Subgroup analysis based on sex, age, race, and vaccination status revealed patients with IDD had a higher HR for primary composite outcome in:
- male subgroups (HR, 1.106; 95% CI, 1.001-1.223),
- female subgroups (HR, 1.175; 95% CI, 1.095-1.273),
- patients within 18 to 64 years (HR, 1.144; 95% CI, 1.069-1.223),
- unvaccinated subgroups (HR, 1.165; 95: CI, 1.069-1.242), and
- White subgroups (HR, 1.148; 95% CI, 1.066-1.236).
The study was limited by inherent biases because of the use of registry databases, communication difficulties, failure to limit all confounding factors, and differences in healthcare systems.
“Our data align with studies by Courtenay et al. and Gleason et al., which document the vulnerability of the IDD population to both COVID-19 and its post-infection sequelae, possibly due to a confluence of intellectual disability and prevalent comorbidities. Further research is needed to elucidate any direct causal relationships,” the researchers concluded.
