Since the onset of the COVID-19 pandemic, the United States has attributed more than 200,000 deaths to the virus and reported 10 million cases. The Centers for Disease Control and Prevention (CDC) associated morbidity with advanced age and certain underlying conditions such as cancer, type 2 diabetes, smoking, COPD, and heart conditions.

A new study by FAIR Health, created in conjunction with a professor from Johns Hopkins University, identified more than 450,000 privately insured “patients diagnosed with COVID-19 from April 1, 2020, through August 31, 2020.”

As part of their review of patient records, researchers “examined the relationships between the outcome of mortality (dependent variable) and the following independent variables: age, gender, and preexisting comorbidities” and developed regression models to see which patients appeared to be the most at risk.

COVID-19 Morbidity

Prior research conducted at the beginning of the pandemic highlighted “associations between greater risk of severe COVID-19 illness and death and patient characteristics, including advanced age, male biological sex, and specific preexisting conditions.” The new study by FAIR Health confirmed much of the data from previous studies, with one of the most striking statistics being the number of biological male mortalities from the virus, which “accounted for 60.7 percent of total COVID-19 deaths, females for 39.93 percent.” One of the reasons that men were more likely to die of the disease was that they were “less likely to be diagnosed with COVID-19, with only 46.22 percent of the total diagnoses attributed to males.”

The study also confirmed that “mortality was much higher” in patients “50 and older, reaching 42.43 percent of all COVID-19 deaths in the age group 70 and over, even though that group had the lowest share of COVID-19 diagnoses, 4.82 percent.”

However, the study found that the highest risk of mortality was not advanced age as previously thought. Rathert, patients “across all age groups” with “developmental disorders (e.g., developmental disorders of speech and language, developmental disorders of scholastic skills, central auditory processing disorders) had the highest odds of dying from COVID-19.” Common developmental disorders include Attention-Deficit/Hyperactivity Disorder (ADHD), autism spectrum disorder, cerebral palsy, muscular dystrophy, learning disorders, vision impairment, and intellectual disabilities.

The study noted that patients with developmental disabilities are more likely to die from COVID-19 due to geographical, economic, and social factors. Patients with developmental disabilities are likely to contract the virus from “group homes and other forms of residential housing.” They are also more likely to contract it because “workers with disabilities are more likely than those without disabilities to be employed in positions that were deemed to be ‘essential’ during the lockdowns in the United States.”

In 2019, workers with a disability “were more likely to hold service occupations, and to hold occupations in production, transportation, and material moving.” This contrasts with workers without disabilities, who were more likely to “work remotely to protect themselves from exposure to COVID-19.”

What This Means for Physicians

The study by FAIR Health revealed that patients with developmental disabilities are at a higher risk of contracting COVID-19 than previously thought. As the pandemic continues and researchers are able to gather more reliable data, it will become more clear which populations are more severely affected by COVID-19. Physicians actively treating patients with COVID-19 may already see such patterns among their patients. As COVID-19 vaccine trials continue and administration plans are rolled out, patients with disabilities may be included as a priority demographic for vaccine administration.

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