People with learning disabilities are five times more likely to be admitted to hospital and eight times more likely to die from COVID-19 than the general population in England, according to a new study.
Writing in today’s edition of The BMJ, the authors say risks were particularly high for those with a severe to profound learning disability, Down’s syndrome and cerebral palsy.
They say their findings warrant prompt access to COVID-19 testing and healthcare for these people – as well as prioritisation for COVID-19 vaccination. Other targeted preventive measures should also be considered.
The UK researchers examined electronic health records for more than 17 million people registered with a general practice in England linked to hospital admission and mortality data, to establish the risk of COVID-19 hospital admissions and deaths among children and adults with a learning disability.
They analysed data for 14,312,023 adults and 2,627,018 children across both waves – 1 March 2020-31 August 2020 and 1 September 2020-February 2021 and found that of the 90,307 adults on the learning disability register, 538 (0.6%) had a COVID-19 related hospital admission and there were 222 (0.25%) COVID-19 related deaths and 602 (0.7%) non-COVID deaths.
Among adults not on the register, 29,781 (0.2%) had a COVID-19 related hospital admission and there were 13,737 (0.1%) COVID-19 related deaths and 69,837 (0.5%) non-COVID deaths.
After taking account of potentially influential factors, such as age, sex, ethnicity, and geographical location, adults on the learning disability register had a five-fold higher risk of COVID-19 related hospital admission and an eight-fold higher risk of COVID-19 related death than adults not on the register.
Rates were higher among those with severe to profound learning disability than those with milder learning disability, and among those in residential care.
Although similar patterns were seen for children, the authors stress that absolute risks of COVID-19 hospital admission and death among children were small.
The authors say there are some limitations to these observational findings, but their results were similar after further analyses, and are consistent with the existing literature, suggesting that they are robust.
They conclude that as well as vaccination, efforts should continue to protect people with learning disability from COVID-19 adverse outcomes, and more research on the excess COVID-19 risks among people with Down’s syndrome and cerebral palsy are needed.
Williamson EJ, McDonald HI, Bhaskaran K et al. Risks of COVID-19 hospital admission and death for people with learning disability: population based cohort study using the OpenSAFELY platform. The BMJ 15 July 2021. DOI: 10.1136/bmj.n1592
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