Postgraduate Program in Health Science, Laboratory of Cell and Molecular Tumor Biology and Bioactive Compounds, São Francisco University, Avenida São Francisco de Assis, 218. Jardim São José, Bragança Paulista, SP, 12916-900, Brazil.
Laboratory of Human and Medical Genetics, São Francisco University, Bragança Paulista, Brazil.
Hum Genet. 2022 Dec;141(12):1887-1904. doi: 10.1007/s00439-022-02468-3. Epub 2022 Jun 28.
Patients with Down syndrome (DS) are more affected by the Coronavirus Disease (COVID)-19 pandemic when compared with other populations. Therefore, the primary aim of our study was to report the death (case fatality rate) from SARS-CoV-2 infection in Brazilian hospitalized patients with DS from 03 January 2020 to 04 April 2021. The secondary objectives were (i) to compare the features of patients with DS and positive for COVID-19 (G1) to those with DS and with a severe acute respiratory infection (SARI) from other etiological factors (G2) to tease apart the unique influence of COVID-19, and (ii) to compare the features of patients with DS and positive for COVID-19 to those without DS, but positive for COVID-19 (G3) to tease apart the unique influence of DS. We obtained the markers for demographic profile, clinical symptoms, comorbidities, and the clinical features for SARI evolution during hospitalization in the first year of the COVID-19 pandemic in Brazil from a Brazilian open-access database. The data were compared between (i) G1 [1619 (0.4%) patients] and G2 [1431 (0.4%) patients]; and between (ii) G1 and G3 [222,181 (64.8%) patients]. The case fatality rate was higher in patients with DS and COVID-19 (G1: 39.2%), followed by individuals from G2 (18.1%) and G3 (14.0%). Patients from G1, when compared to G2, were older (≥ 25 years of age), presented more clinical symptoms related to severe illness and comorbidities, needed intensive care unit (ICU) treatment and non-invasive mechanical ventilation (MV) more frequently, and presented a nearly two fold-increased chance of death (OR = 2.92 [95% CI 2.44-3.50]). Patients from G1, when compared to G3, were younger (< 24 years of age), more prone to nosocomial infection, presented an increased chance for clinical symptoms related to a more severe illness; frequently needed ICU treatment, and invasive and non-invasive MV, and raised almost a three fold-increased chance of death (OR = 3.96 [95% CI 3.60-4.41]). The high case fatality rate in G1 was associated with older age (≥ 25 years of age), presence of clinical symptoms, and comorbidities, such as obesity, related to a more severe clinical condition. Unvaccinated patients with DS affected by COVID-19 had a high case fatality rate, and these patients had a different profile for comorbidities, clinical symptoms, and treatment (such as the need for ICU and MV) when compared with other study populations.
唐氏综合征（DS）患者在冠状病毒病（COVID-19）大流行期间比其他人群受到更大的影响。因此，我们研究的主要目的是报告 2020 年 1 月 3 日至 2021 年 4 月 4 日巴西住院 DS 患者因 SARS-CoV-2 感染而死亡（病死率）。次要目的是（i）比较 DS 患者和 COVID-19 阳性（G1）与 DS 患者和其他病因 SARI 阳性（G2）的特征，以剖析 COVID-19 的独特影响，（ii）比较 DS 患者和 COVID-19 阳性与非 DS 但 COVID-19 阳性（G3）的特征，以剖析 DS 的独特影响。我们从巴西的一个开放获取数据库中获得了 COVID-19 大流行第一年巴西的人口统计学特征、临床症状、合并症和住院期间 SARI 演变的临床特征。数据在（i）G1[1619（0.4%）患者]和 G2[1431（0.4%）患者]之间进行比较；在（ii）G1 和 G3[222,181（64.8%）患者]之间进行比较。DS 合并 COVID-19 患者（G1：39.2%）的病死率高于 G2（18.1%）和 G3（14.0%）患者。与 G2 相比，G1 患者年龄更大（≥25 岁），与严重疾病和合并症相关的临床症状更多，更需要重症监护病房（ICU）治疗和无创机械通气（MV），死亡风险增加近两倍（OR=2.92[95%CI 2.44-3.50]）。与 G3 相比，G1 患者年龄更小（<24 岁），更易发生医院感染，更易出现与更严重疾病相关的临床症状；更常需要 ICU 治疗、有创和无创 MV，死亡风险增加近三倍（OR=3.96[95%CI 3.60-4.41]）。G1 中的高病死率与年龄较大（≥25 岁）、存在临床症状和肥胖等与更严重临床状况相关的合并症有关。未接种疫苗的 COVID-19 感染 DS 患者病死率高，与其他研究人群相比，这些患者的合并症、临床症状和治疗（如需要 ICU 和 MV）特征不同。
