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Published on: September 30, 2020
Short-term mortality and the impact of disability type following COVID-19 among individuals with disabilities: A
Yoonjeong Choi1, Gi Hwan Bae2, Jihui Jeon1
1Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Republic of Korea; National Traffic Injury Rehabilitation Research Institute, National Traffic Injury Rehabilitation Hospital, Yangpyeong, Republic of Korea.
Objectives:
Individuals with disabilities may face heightened short-term mortality post-COVID-19; however, prior studies primarily examined long-term mortality. We evaluated 4-week mortality risk after COVID-19 among people with disabilities.
Methods:
Using national COVID-19 registry linked with Korean National Health Insurance Service claims data, we constructed a retrospective cohort of 2729,089 individuals with disabilities (2020-2021). After excluding those with disability status/type changes, aged <18 years, with missing data, or unmatched by propensity score, 26,210 individuals with COVID-19 and 1928,650 controls were included. Inverse probability of treatment weighting (IPTW) and Cox proportional hazards models estimated 4-week mortality risk, with subgroup analyses by disability severity, type, and infection timing.
Results:
The 4-week mortality risk was 11 times higher in COVID-19 patients than controls, with similar results after IPTW. Short-term mortality risk was similar in those with mild and severe disabilities, but was highest among individuals with internal organ disorders and adults aged 65 years and older. Short-term mortality hazard ratios were similar pre- and post-SARS-CoV-2 Delta variant epidemic, though risk was highest in Q4 2020.
Conclusion:
COVID-19 substantially increased short-term mortality among people with disabilities, especially those with internal organ disorders and older adults. Policies to prepare these high-risk populations for respiratory epidemics are needed.
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