People with developmental disabilities who contract COVID-19 face a higher risk of dying from the virus than just about anyone else, new research indicates.

A review of private health insurance claims data for 467,773 people diagnosed with the coronavirus in the U.S. between April and August finds that individuals with developmental disorders are three times more likely to die compared to others.

That’s the highest risk of any of the 15 conditions that the study looked at, which included heart failure, chronic kidney disease, liver disease and various types of cancer.

Meanwhile, a separate category for people with intellectual disabilities and related conditions like Down syndrome showed a risk of death 2.75 times higher and was third on the list of conditions. That was followed by spina bifida and other nervous system anomalies.

Lung cancer, with a nearly threefold increased risk, was the only other condition to rival the rate of death seen in those with developmental disorders and intellectual disabilities.

The study, which was released this month as a white paper and is not yet published in a medical journal, comes from FAIR Health, a nonprofit with the nation’s largest private health care claims database, in conjunction with the West Health Institute and Marty Makary of the Johns Hopkins University School of Medicine.

The findings largely mirror those from a handful of other studies that have looked specifically at the fate of people with developmental disabilities during the pandemic. But, the new review puts into context how the risk facing individuals with developmental disabilities exceeds that of those with nearly every other condition, no matter their age.

The analysis comes as plans are ongoing to determine how a COVID-19 vaccine will be allocated when it becomes available. Disability advocates have complained that preliminary government proposals have not adequately prioritized people with developmental disabilities.

“As we edge closer to a vaccine for the SARS-CoV-2 virus, the insights generated by this analysis will be critical to informing vaccine distribution among the most vulnerable,” said Tim Lash, chief strategy officer and executive vice president at the West Health Institute, one of the groups behind the new report.

Researchers said that a number of factors may contribute to the higher risk of death seen in those with developmental disorders and intellectual disabilities. These individuals are more likely to have other chronic health conditions, live in group homes and other congregate settings, are disproportionately employed in essential services and they are more reliant on public transportation and devices like wheelchairs that need to be disinfected.