New research suggests that people with intellectual disability are about six times more likely to die if they contract COVID-19, a higher risk than almost anyone else.

A review of 64 million medical records from individuals seen by 547 health care organizations across the U.S. between January 2019 and November 2020 finds that intellectual disability is the greatest risk factor — other than old age — associated with COVID-19 deaths.

“The chances of dying from COVID-19 are higher for those with intellectual disability than they are for people with congestive heart failure, kidney disease or lung disease,” said Jonathan Gleason, chief quality officer at Jefferson Health in Philadelphia and the lead author of the study published this month in the New England Journal of Medicine Catalyst.

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“That is a profound realization that we have not, as a health care community, fully appreciated until now,” he said.

The study found that people with intellectual disabilities were 2.5 times more likely than others to be diagnosed with COVID-19 and 2.7 times more likely to be hospitalized. And, they were 5.9 times more likely to die as a result of the virus.

That means that “having an intellectual disability was the strongest independent risk factor for presenting with a COVID-19 diagnosis and the strongest independent risk factor other than age for COVID-19 mortality,” the study found.

The increased risk could be related to the inability of people in this population to socially distance, wear masks or follow other practices to reduce exposure to COVID-19, the researchers said. But, individuals with intellectual disabilities are also more prone to other health conditions that would make them vulnerable to the virus, they said.

The study is just the latest to highlight the elevated risk faced by those with developmental disabilities. It comes as advocates continue to fight for people in this population to be prioritized for access to COVID-19 vaccines. To date, there is a patchwork approach across the country whereby some states and localities have granted access to people with developmental disabilities while others have not.

“We need to understand more about what is happening with these patients,” Gleason said. “I do believe these patients and their caregivers should be prioritized for vaccination and health care services. We should reflect on why we have failed this vulnerable population, and how we can better serve them during this health crisis, and into the future.”