Department of Medicine, Tirunelveli Medical College and Hospital, Tirunelveli, India.
Department of Medicine, Velammal Medical College Hospital and Research Institute, Madurai, India.
Immun Inflamm Dis. 2024 Mar;12(3):e1219. doi: 10.1002/iid3.1219.
Down syndrome (DS) is associated with multiple comorbid conditions and chronic immune dysfunction. Persons with DS who contract COVID-19 are at high risk for complications and have a poor prognosis. We aimed to study the clinical symptoms, laboratory and biochemical profiles, radiologic findings, treatment, and outcomes of patients with DS and COVID-19.
We systematically searched PubMed, MEDLINE, Web of Science, Scopus, and the Cochrane Library using the keywords COVID-19 or coronavirus or SARS-CoV-2 and DS or trisomy 21. Seventeen articles were identified: eight case reports and nine case series published from December 2019 through March 2022, with a total of 55 cases.
Patients averaged 24.8 years (26 days to 60 years); 29 of the patients were male. The most common symptoms were fever, dyspnea, and cough. Gastrointestinal and upper respiratory tract symptoms were commonly reported for pediatric patients. The most common comorbidities present in patients with DS were obesity (49.0%), hypothyroidism (21.6%) and obstructive sleep apnea (15.6%). The patients were hospitalized for a mean of 14.8 days. When the patients were compared with the general COVID-19 population, the mean number of hospitalized days was higher. Most patients had leukopenia, lymphopenia, and elevated inflammatory markers (d-dimer and C-reactive protein). Bilateral infiltrations and bilateral ground-glass opacifications were frequently seen in chest radiographs and chest computed tomographic imaging. Most of the patients were treated with methylprednisolone, macrolides, and hydroxychloroquine. Of the 55 patients, 22 died. The mean age of the patients who died was 42.8 years. Mortality rate was higher in individuals with DS over 40 years of age.
More studies are needed to better understand COVID-19 infections among persons with DS. In addition, the study was limited by a lack of statistical analyses and a specific comparison group.
唐氏综合征（DS）与多种合并症和慢性免疫功能障碍有关。感染 COVID-19 的 DS 患者并发症风险高，预后不良。我们旨在研究 COVID-19 患者的临床症状、实验室和生化特征、影像学表现、治疗和结局。
我们系统地在 PubMed、MEDLINE、Web of Science、Scopus 和 Cochrane Library 上使用 COVID-19 或冠状病毒或 SARS-CoV-2 和 DS 或 21 三体这两个关键词进行了搜索。确定了 17 篇文章：2019 年 12 月至 2022 年 3 月发表的 8 篇病例报告和 9 篇病例系列，共 55 例。
患者平均年龄为 24.8 岁（26 天至 60 岁）；29 名患者为男性。最常见的症状是发热、呼吸困难和咳嗽。胃肠道和上呼吸道症状在儿科患者中常见。DS 患者最常见的合并症为肥胖症（49.0%）、甲状腺功能减退症（21.6%）和阻塞性睡眠呼吸暂停（15.6%）。患者平均住院 14.8 天。与普通 COVID-19 人群相比，患者的平均住院天数更高。大多数患者白细胞减少、淋巴细胞减少和炎症标志物（D-二聚体和 C 反应蛋白）升高。胸部 X 线和胸部 CT 成像常可见双侧浸润和双侧磨玻璃影。大多数患者接受了甲基强的松龙、大环内酯类药物和羟氯喹治疗。55 例患者中，22 例死亡。死亡患者的平均年龄为 42.8 岁。40 岁以上个体的死亡率更高。
需要更多的研究来更好地了解 DS 患者的 COVID-19 感染。此外，该研究受到缺乏统计分析和特定对照组的限制。
