COVID-19 clinical outcomes by patient disability status: A retrospective cohort study.

Autor: Deal JA; Department 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., Jiang K; Department 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., Betz JF; Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA., Clemens GD; Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA., Zhu J; Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA., Reed NS; Department 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., Garibaldi BT; Division of Pulmonary and Critical Care Medicine and Johns Hopkins Biocontainment Unit, Johns Hopkins University School of Medicine, Baltimore, MD, USA., Swenor BK; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Johns Hopkins Disability Health Research Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Johns Hopkins University School of Nursing, Baltimore, MD, USA. Electronic address: bswenor@jhmi.edu.
Jazyk: angličtina
Zdroj: Disability and health journal [Disabil Health J] 2023 Apr; Vol. 16 (2), pp. 101441. Date of Electronic Publication: 2023 Jan 12.
DOI: 10.1016/j.dhjo.2023.101441
Abstrakt: 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.
Competing Interests: Conflicts of interest Mr. Betz reported equity and entitlement to future royalties from miDiagnostics. Dr. Reed reported membership on the advisory board of Neosensory. Dr. Garibaldi reported consulting fees from Janssen Research and Development, LLC, Gilead Sciences Inc, and Atea Pharmaceuticals Inc, and is also a member of the FDA Pulmonary-Asthma Drug Advisory Committee. Dr. Swenor is an advisor to the Innovation and Value Initiative. No other disclosures were reported.
(Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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