COVID-19 among people with intellectual disability in comparison to the general population: diagnoses, hospitalizations, deaths, and vaccinations (IDcare)

BACKGROUND: People with intellectual disabilities (ID) were identified as one of the vulnerable groups during the COVID-19 pandemic. However, few studies have investigated a comprehensive set of COVID-19-related outcomes. The aim of this study is therefore to describe COVID-19-related diagnoses, hospitalizations, deaths, and vaccinations among people with ID compared to the general population. METHODS: This register-based cohort study included all people living in Skåne, Sweden, on January 1st, 2014. People with ID and still alive January 1st, 2020, constituted the ID cohort (n = 14 046). Those remaining after excluding people in the same family/household comprised the general population cohort (gPop, n = 1 157 138). Data regarding outcomes were collected from Swedish national and regional registers for 2020 and 2021. RESULTS: People in the ID cohort had higher risk of being diagnosed with COVID-19 but were less likely than those in the gPop cohort to have the diagnosis confirmed by laboratory test. Adults and older people in the ID cohort had higher COVID-19 related healthcare utilization in terms of physical primary care visits in 2020 and hospitalizations in both 2020 and 2021, with some sex and age differences within the ID cohort. Among those with at least one physical primary care contact, adults and older women in the ID cohort had fewer contacts in 2020 compared to their peers in the gPop cohort. Where the number of observations allowed for analyses, people in the ID cohort had higher risk of death from COVID-19 than those in the gPop cohort. CONCLUSIONS: People with ID had similar healthcare utilization as the general population during the COVID-19 pandemic, with the same or higher levels of COVID-related healthcare, and similar vaccination rates. However, people with ID with healthcare contacts had fewer contacts and bed days and higher mortality. Overall, the Swedish COVID-19 strategy regarding vaccination and healthcare prioritization for people with ID seems to have worked as intended.