Related Experiment Video
Updated: Aug 10, 2025
Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
Published on: September 30, 2020
COVID-19 clinical outcomes by patient disability status: A retrospective cohort study
Jennifer A Deal1, Kening Jiang2, Joshua F Betz3
1Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Johns Hopkins Disability Health Research Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Insights
People with disabilities requiring assistance, especially those under 65, face a higher risk of severe COVID-19. This study highlights the need for better disability data collection in healthcare to understand these disparities.
Area of Science:
- Public Health
- Epidemiology
- Clinical Medicine
Background:
- Limited evidence exists on the clinical outcomes of SARS-CoV-2 infection in people with disabilities.
- Disparities in healthcare access and outcomes are a significant concern for vulnerable populations.
Purpose of the Study:
- To investigate the association between disability status and the risk of severe COVID-19 or death.
- To identify specific risk factors and outcomes for individuals with disabilities during the pandemic.
Main Methods:
- Utilized data from the Johns Hopkins COVID-19 Precision Medicine Analytics Platform Registry (JH-CROWN) including 6494 adult patients.
- Employed multivariable-adjusted Cox proportional hazards models to analyze the association between disability and severe COVID-19 or death.
- Defined severe COVID-19 and death based on clinical events and adjusted for demographic and clinical covariates.
Main Results:
- Patients with disabilities requiring assistance aged under 65 had a 1.35 times higher hazard of severe COVID-19.
- This translates to an additional 17.5 severe COVID-19 cases per 100 patients in this age group.
- No significant difference in mortality risk was observed for those under 65, though this finding was limited by a small number of deaths.
Conclusions:
- Individuals with disabilities requiring assistance, particularly those under 65, are more prone to severe COVID-19 outcomes.
- The study acknowledges limitations, including the use of a medical model of disability.
- Highlights the critical need for standardized disability data collection within electronic health records for improved research and patient care.
Background:
People with disabilities might experience worse clinical outcomes of SARS-CoV-2 infection, but evidence is limited.
Objective:
To investigate if people with disabilities requiring assistance are more likely to experience severe COVID-19 or death.
Methods:
Data from the Johns Hopkins COVID-19 Precision Medicine Analytics Platform Registry (JH-CROWN) included 6494 adult patients diagnosed with COVID-19 and admitted between March 4, 2020-October 29, 2021. Severe COVID-19 and death were defined using the occurrence and timing of clinical events. Assistive needs due to disabilities were reported by patients or their proxies upon admission. Multivariable-adjusted Cox proportional hazards models were used to examine the associations between disability status and severe COVID-19 or death. Primary models adjusted for demographics and secondary models additionally adjusted for clinical covariates.
Results:
In this clinical cohort (47-73 years, 49% female, 39% Black), patients with disabilities requiring assistance had 1.35 times (95% confidence interval [CI]:1.01, 1.81) the hazard of severe COVID-19 among patients <65 years, but not among those ≥65 years, equating to an additional 17.5 severe COVID-19 cases (95% CI:7.7, 28.2) per 100 patients. A lower risk of mortality was found among patients <65 years, but this finding was not robust due to the small number of deaths.
Conclusions:
People with disabilities requiring assistance aged <65 years are more likely to develop severe COVID-19. Although our study is limited by using a medical model of disability, these analyses intend to further our understanding of COVID-19 outcomes among people with disabilities. Also, standardized disability data collection within electronic health records is needed.
Related Concept Videos
01:27Chronic Obstructive Pulmonary Disease-IV: Assessement and Diagnostic Studies
Medical History
01:20COPD: Pathogenesis and Clinical Features
The primary cause for the onset of COPD is cigarette smoking and exposure to air pollution. These hazardous factors initiate a chain reaction within the lungs, resulting in chronic inflammation, damage to the airways, and a...
01:25Learning Disabilities
Dyslexia
Dyslexia is a...
01:22Chronic Obstructive Pulmonary Disease
Smoking is a primary risk factor for COPD, with over 80% of patients having a history of it. Patients typically experience progressive dyspnea or labored breathing, frequent coughing, and recurrent pulmonary infections. Many eventually succumb to respiratory failure, characterized by...
01:29Intellectual Disability
01:29Chronic Obstructive Pulmonary Disease-V: Management
Smoking Cessation