Clinical characteristics of individuals with Down syndrome deceased with CoVID‐19 in Italy—A case series

Abstract

BACKGROUND: Persons with Down syndrome (DS) are presumed to be at high risk of severe CoVID-19, due to immune dysregulation and often compromised cardiopulmonary function. Aim of the present study is to assess epidemiological and clinical characteristics of individuals with DS deceased in Italian hospitals with CoVID-19. METHODS: We used a nationwide database of 3,438 patients deceased with RT-PCR-confirmed SARS-CoV-2 infection in Italy (10.4% of all deaths with CoVID-19 in the country at the time of analysis). Data on demographics, pre-existing comorbidities and in-hospital complications leading to death were extracted from medical charts obtained from hospitals. Data on individuals with DS deceased with CoVID-19 were obtained from this sample. RESULTS: Sixteen cases of death in individuals with DS (0.5% of all charts analyzed) were identified. Acute respiratory distress syndrome occurred in all 16 cases. Compared with individuals without DS, those with DS deceased with CoVID-19 were younger (52.3 ± 7.3 vs. 78.1 ± 10.6 years, p < .001) and presented a higher incidence of superinfections (31.2 vs. 13.0%, p = .029). Autoimmune diseases (43.8 vs. 4%, p < .001), obesity (37.5 vs. 11%, p = .009), and dementia (37.5 vs. 16.3%, p = .012

JAK1 Inhibition Blocks Lethal Immune Hypersensitivity in a Mouse Model of Down Syndrome

“…In the context of the current COVID-19 pandemic, our results indicate that people with DS, who carry an extra copy of the four IFNRs encoded on chr21, should be considered a highrisk population for complications driven by SARS-CoV-2induced hyperinflammation. As observed with RSV (Beckhaus and Castro-Rodriguez, 2018) and H1N1 (Pé rez-Padilla et al, 2010) infection, people with DS are likely to develop more severe complications upon SARS-CoV-2 infection, including higher rates of hospitalization, mortality, and secondary bacterial infection (De Cauwer and Spaepen, 2020;Espinosa, 2020;Villani et al, 2020). A recent evaluation of 8 million medical records revealed a 4-fold higher rate of hospitalization and 10-fold higher rate of death for adults with DS affected by COVID-19 (Clift et al, 2020).…”

Specialty clinics for adults with Down syndrome: A clinic survey

“…The impact of state laws restricting telemedicine consultations was mentioned; emphasizes that the ideal model likely differs by practice location. This survey was initiated in 2019 prior to the onset of the COVID‐19 pandemic; clinics may have changed their plans to incorporate telemedicine, and it would be of interest to repeat this survey in the current climate (Clift et al, 2020; Villani et al, 2020).…”

Interferon-Driven Immune Dysregulation in Down Syndrome: A Review of the Evidence

“…14,15,17 However, individuals with DS have a paradoxical susceptibility to certain viral infections, with higher mortality rates due to SARS-CoV2 and respiratory syncytial virus (RSV) infections. [18][19][20][21][22][23] The mismatch We present here the results of a comprehensive review of the available clinical, immunological, and molecular evidence for interferonopathy in DS and highlight possible future directions for extracting the maximal benefit to the DS community from research findings.…”