Exposure to COVID-19 Infection and Mortality Rates Among People With Disabilities in South Korea

Background: With the delayed eradication of coronavirus disease 2019 (COVID-19), people with disabilities, a socially vulnerable class of individuals, face aggravated hardships caused by a pause in support services and lack of care due to stricter social distancing policies combined with the challenges of their disabilities. Given this background, we aim to investigate COVID-19 infection and mortality rates among people with disabilities, who face heightened physical and mental health threats amidst the COVID-19 pandemic. Methods: Gender, age, health insurance premiums, the Charlson Comorbidity Index (CCI), the severity of the disability, and the type of disability were compared among people with disabilities who had been infected with or died from COVID-19 using the nationally representative National Health Insurance Service (NHIS)-COVID-19 database (DB). Results: We found that the COVID-19 infection rate was higher among those with low income, those with severe disability, and those with "other" disabilities (ie, speech disabilities, hepatic dysfunction, respiratory dysfunction, facial disfigurement, intestinal fistular/urinary disability, epilepsy, intellectual disability, autistic disorder, and mental disorders). The mortality rate was markedly higher (ie, 15.90 times higher, odds ratio [OR]: 15.90, 95% confidence interval [CI]: 6.16 - 41.06) among people aged 80 years or older as compared with those aged 60 years or younger. The odds for mortality were 2.49 times higher (OR: 2.49, 95% CI: 1.33 - 4.64) among people with severe disabilities as compared with mild disabilities. Conclusion: Among people with disabilities, we found that COVID-19 infection rates differed according to income level, severity of the disability, and disability type, while the COVID-19 mortality rates differed according to age and severity of the disability.