Hüls Anke, Costa Alberto C S, Dierssen Mara, Baksh R Asaad, Bargagna Stefania, Baumer Nicole T, Brandão Ana Claudia, Carfi Angelo, Carmona-Iragui Maria, Chicoine Brain Allen, Ghosh Sujay, Lakhanpaul Monica, Manso Coral, Mayer Miguel-Angel, Del Carmen Ortega Maria, de Asua Diego Real, Rebillat Anne-Sophie, Russell Lauren Ashley, Sgandurra Giuseppina, Valentini Diletta, Sherman Stephanie L, Strydom Andre
medRxiv. 2020 Nov 5:2020.11.03.20225359. doi: 10.1101/2020.11.03.20225359.
Health conditions and immune dysfunction associated with trisomy 21 (Down syndrome, DS) may impact the clinical course of COVID-19 once infected by SARS-CoV-2.
The T21RS COVID-19 Initiative launched an international survey for clinicians or caregivers/family members on patients with COVID-19 and DS (N=1046). De-identified survey data collected between April and October 2020 were analysed and compared with the UK ISARIC4C survey of hospitalized COVID-19 patients with and without DS. COVID-19 patients with DS from the ISARIC4C survey (ISARIC4C DS cases=100) were matched to a random set of patients without DS (ISARIC4C controls=400) and hospitalized DS cases in the T21RS survey (T21RS DS cases=100) based on age, gender, and ethnicity.
The mean age in the T21RS survey was 29 years (SD=18), 73% lived with their family. Similar to the general population, the most frequent signs and symptoms of COVID-19 were fever, cough, and shortness of breath. Pain and nausea were reported less frequently (p<0.01), whereas altered consciousness/confusion were reported more frequently (p<0.01). Risk factors for hospitalization and mortality were similar to the general population (age, male gender, diabetes, obesity, dementia) with the addition of congenital heart defects as a risk factor for hospitalization. Mortality rates showed a rapid increase from age 40 and were higher than for controls (T21RS DS versus controls: risk ratio (RR)=3.5 (95%-CI=2.6;4.4), ISARIC4C DS versus controls: RR=2.9 (95%-CI=2.1;3.8)) even after adjusting for known risk factors for COVID-19 mortality.
Leading signs/symptoms of COVID-19 and risk factors for severe disease course are similar to the general population. However, individuals with DS present significantly higher rates of mortality, especially from age 40.
Down Syndrome Affiliates in Action, Down Syndrome Medical Interest Group-USA, GiGi's Playhouse, Jerome Lejeune Foundation, LuMind IDSC Foundation, Matthews Foundation, National Down Syndrome Society, National Task Group on Intellectual Disabilities and Dementia Practices.
与21三体综合征（唐氏综合征，DS）相关的健康状况和免疫功能障碍可能会在感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）后影响新型冠状病毒肺炎（COVID-19）的临床病程。
T21RS COVID-19倡议组织针对临床医生或COVID-19和DS患者的护理人员/家庭成员开展了一项国际调查（N = 1046）。对2020年4月至10月期间收集的去识别化调查数据进行分析，并与英国ISARIC4C对住院的有或无DS的COVID-19患者的调查进行比较。根据年龄、性别和种族，将ISARIC4C调查中的DS COVID-19患者（ISARIC4C DS病例 = 100）与一组随机抽取的无DS患者（ISARIC4C对照 = 400）以及T21RS调查中的住院DS病例（T21RS DS病例 = 100）进行匹配。
T21RS调查中的平均年龄为29岁（标准差 = 18），73%与家人同住。与普通人群相似，COVID-19最常见的体征和症状是发热、咳嗽和呼吸急促。疼痛和恶心的报告频率较低（p<0.01），而意识改变/混乱的报告频率较高（p<0.01）。住院和死亡的危险因素与普通人群相似（年龄、男性、糖尿病、肥胖、痴呆），此外先天性心脏病是住院的危险因素。死亡率从40岁起迅速上升，且高于对照组（T21RS DS与对照组：风险比（RR） = 3.5（95%置信区间 = 2.6；4.4），ISARIC4C DS与对照组：RR = 2.9（95%置信区间 = 2.1；3.8）），即使在调整了已知的COVID-19死亡危险因素之后。
COVID-19的主要体征/症状和重症病程的危险因素与普通人群相似。然而，DS患者的死亡率显著更高，尤其是40岁及以上人群。
唐氏综合征行动联盟、美国唐氏综合征医学兴趣小组、吉吉儿童乐园、杰罗姆·勒琼基金会、鲁明德国际唐氏综合征中心基金会、马修斯基金会、美国国家唐氏综合征协会、智障与痴呆症实践国家任务组。
