Short-Term Mortality and the Impact of Disability Type Following COVID-19 Among Individuals with Disabilities: A Population-Based Study

ABSTRACT 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 2,729,089 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 1,928,650 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.