Original Title: État des pratiques - Risques d’hospitalisation et de décès en lien avec la COVID-19 chez les personnes avec une déficience intellectuelle (DI) ou un trouble du spectre de l’autisme (TSA)

Authors' objectives: The COVID-19 pandemic has had a significant impact on the health of the entire population, particularly among the elderly and those with vulnerabilities such as intellectual disabilities (ID) or autism spectrum disorder (ASD) [Baweja et al., 2022; Lunsky et al., 2022; Friedman, 2021]. According to the international literature, people with an ID or ASD have generally been at greater risk than the general population for SARS-CoV-2 infection, as well as for complications and serious adverse events associated with the disease.

Authors' results and conclusions: RESULTS: (#1: ID-ASD Cohort Characteristics): The cohort of individuals with an intellectual disability (ID) or autism spectrum disorder (ASD) (ID-ASD cohort)1 was identified using the diagnostic and service codes found in Quebec’s clinical administrative databases. • This cohort includes approximately 69,000 people with an ID, 58,000 people with ASD and 20,000 people with both conditions (ID and ASD). • The analysis includes all cases of infection with the SARS-CoV-2 virus between March 1, 2020 (start of the first wave) and December 4, 2021 (end of the fourth wave). • Data for the fifth wave was not considered in the analysis because, as of the onset of this wave, the health and social services system stopped providing accurate counts of the number of cases of infection. (#2: Hospitalization): After adjustment,2 the risk of hospitalization for people in the ID-ASD cohort with a confirmed COVID-19 infection varied according to their health condition. Compared to COVID-19 cases in the rest of the population: – there was no difference in the risk of being hospitalized among people with ASD; – people with an ID were 1.75 times more at risk of being hospitalized; – people presenting both an ID and ASD were 3.23 times more at risk of being hospitalized. (#3: Death): After adjustment, the risk of death for people in the ID-ASD cohort with a confirmed COVID-19 infection varied according to their health problems. Compared to COVID-19 cases in the rest of the population: – there was no difference in the risk of death among people with ASD; – people presenting an ID were 1.39 times more at risk of dying; – people with both an ID and ASD were 1.97 times more at risk of dying. CONCLUSION: This increased risk of death in individuals with an ID can be explained, at least in part, by the severity of the comorbidities that many of them present. In fact, nearly 30% of people with a confirmed infection and an ID were housed in a long-term care facility (CHSLD) or in an intermediate or family-type residence (RI-RTF), and they generally presented serious comorbidities. The results of the analyses were adjusted to take into account the number of health problems, but not their severity, because this variable is poorly captured in the databases used.

Authors' methods: In order to examine the specific situation in Quebec, an analysis was carried out on the risks of hospitalization and death from COVID-19 in people with a confirmed SARS-CoV2 infection and presenting an ID or ASD, as compared to the general population. The individuals in the ID-ASD cohort were identified from Quebec’s clinical administrative databases. It is important to note that this data does not reflect the situation of everyone in Quebec with an ID or ASD but rather the situation of the population covered by the Quebec Health Insurance Plan between March 1, 2020 and December 4, 2021 and who have a diagnosis or have received services related to an ID or ASD.

Project Status: Completed

URL for project: https://www.inesss.qc.ca/en/publications/publications/publication/risques-dhospitalisation-et-de-deces-en-lien-avec-la-covid-19-chez-les-personnes-avec-une-deficience-intellectuelle-di-ou-un-trouble-du-spectre-de-lautisme-tsa.html

Year Published: 2022

URL for published report: https://www.inesss.qc.ca/en/publications/publications/publication/risques-dhospitalisation-et-de-deces-en-lien-avec-la-covid-19-chez-les-personnes-avec-une-deficience-intellectuelle-di-ou-un-trouble-du-spectre-de-lautisme-tsa.html

English language abstract: An English language summary is available

Publication Type: Other

Country: Canada

Province: Quebec

Organisation Name: Institut national d'excellence en sante et en services sociaux

Contact Address: L'Institut national d'excellence en sante et en services sociaux (INESSS) , 2021, avenue Union, bureau 10.083, Montreal, Quebec, Canada, H3A 2S9;Tel: 1+514-873-2563, Fax: 1+514-873-1369

Contact Name: demande@inesss.qc.ca

Contact Email: demande@inesss.qc.ca

Copyright: Gouvernement du Québec