J Korean Med Sci.  2025 Feb;40(7):e37. 10.3346/jkms.2025.40.e37.

Age-Stratified Risk of Severe COVID-19 for People With Disabilities in Korea: Nationwide Study Considering Disability Type

• Ryu B
• Jang H
• Kim J
• Cho Si
• Kim SS

• KMID: 2565175
• DOI: http://doi.org/10.3346/jkms.2025.40.e37

Abstract

Background
Understanding disparities in severe coronavirus disease 2019 (COVID-19) outcomes between people with disabilities (PwD) and people without disabilities (PwoD) is crucial, particularly when considering the heterogeneity within PwD and age differences. This study aimed to compare severe COVID-19 outcomes including deaths between PwD and PwoD with analyses stratified by age group and further examined by disability type.
Methods
This retrospective, population-based cohort study used linked data from national COVID-19 cases and health insurance for individuals aged ≥ 19 years with COVID-19 from January 2020 to October 2022 in the Republic of Korea. Severe outcomes included severe cases and deaths, with logistic regression analysis of the risk disparities between PwD and PwoD based on age group and disability types. The subgroup analysis considered epidemic periods, accounting for the severe acute respiratory syndrome coronavirus 2 variant circulation.
Results
The risk of severe COVID-19 outcomes and deaths among PwD varied by age and disability type. While severe outcomes were most prevalent in the older age groups for both PwD and PwoD, younger PwD faced a markedly higher risk—up to eightfold—compared to PwoD. The risk of disability status was greater than that of comorbidities in the 19–39 age group. Among disability types, individuals with internal organs-related and intellectual disabilities showed higher risk disparities with PwoD in severe outcomes than other types of disabilities. Throughout the pandemic, the disparity in death risk remained similar, with a slight increase in disparity during the omicron period for all severe outcomes in the age groups 19–39 and 40–64 years.
Conclusion
Prioritizing younger PwD, along with older age groups and people with comorbidities, is crucial in addressing public health crises. Risk-based prioritization is important to reduce overall risk. This includes prioritizing people with nternal organs-related and intellectural disabilities, who face higher health risks among PwD during a pandemic when resources are limited and time is of the essence.

Keyword

SARS-CoV-2; People With Disabilities; Severity; Fatality; Disability Types; Age Stratification

Figure

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  Fig. 1 Adjusted odds ratios of severe outcomes and deaths among people with and without disability based on age groups and circulating variant period, all severe outcomes (A), deaths (B).aOR = adjusted odds ratio, CI = confidence interval.

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