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意大利死于 COVID-19 的唐氏综合征个体的临床特征:一项病例系列研究。

Clinical characteristics of individuals with Down syndrome deceased with CoVID-19 in Italy-A case series.

机构信息

Department of Geriatrics, Catholic University of the Sacred Heart, Rome, Italy.

Department of Geriatrics, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy.

出版信息

Am J Med Genet A. 2020 Dec;182(12):2964-2970. doi: 10.1002/ajmg.a.61867. Epub 2020 Sep 12.

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) were more prevalent in individuals with DS. ICU admissions was similar in both groups (25 vs. 18.8%, p = .129).

CONCLUSIONS

Individuals with DS deceased with CoVID-19 are younger than individuals without DS. Comorbidity burden and increased risk of complications (i.e., bacterial superinfections) can influence CoVID-19 prognosis in individuals with DS. Specific strategies to prevent and mitigate the effects of CoVID-19 in the population with DS are needed.

摘要

背景

唐氏综合征(DS)患者由于免疫失调和经常受损的心肺功能,被认为患有严重的 CoVID-19 的风险较高。本研究的目的是评估在意大利医院因 CoVID-19 死亡的 DS 患者的流行病学和临床特征。

方法

我们使用了意大利一个包含 3438 名经 RT-PCR 确诊为 SARS-CoV-2 感染死亡患者的全国性数据库(在分析时占该国所有 CoVID-19 死亡人数的 10.4%)。从从医院获得的病历中提取了人口统计学、预先存在的合并症和导致死亡的院内并发症的数据。从该样本中获得了患有 CoVID-19 的 DS 患者死亡的数据。

结果

在 16 名患有 DS 的个体中发现了 16 例死亡病例(分析的所有图表的 0.5%)。所有 16 例均发生急性呼吸窘迫综合征。与无 DS 的个体相比,患有 CoVID-19 的 DS 患者死亡时年龄较小(52.3±7.3 岁与 78.1±10.6 岁,p<0.001),并且更易发生继发感染(31.2%与 13.0%,p=0.029)。自身免疫性疾病(43.8%与 4%,p<0.001)、肥胖(37.5%与 11%,p=0.009)和痴呆(37.5%与 16.3%,p=0.012)在 DS 患者中更为常见。两组的 ICU 入院率相似(25 例与 18.8%,p=0.129)。

结论

患有 CoVID-19 的 DS 患者死亡时比没有 DS 的患者年轻。合并症负担和并发症风险增加(即细菌继发感染)可能会影响 DS 患者的 CoVID-19 预后。需要制定针对 DS 人群预防和减轻 CoVID-19 影响的具体策略。

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