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. 2022 Sep 13;226(5):757-765.
doi: 10.1093/infdis/jiac236.

Risk of Severe Coronavirus Disease 2019 Disease in Individuals With Down Syndrome: A Matched Cohort Study From a Large, Integrated Health Care System

Jennifer H Ku  1 , Myron J Levin  2 , Yi Luo  1 , Ana Florea  1 , I Chun Lin  1 , Yun Tian  1 , Hung Fu Tseng  1
Affiliations

Risk of Severe Coronavirus Disease 2019 Disease in Individuals With Down Syndrome: A Matched Cohort Study From a Large, Integrated Health Care System

Jennifer H Ku et al. J Infect Dis. .

Abstract

Background: Down syndrome (DS) is associated with an increased risk of infections attributed to immune defects. Whether individuals with DS are at an increased risk of severe coronavirus disease 2019 (COVID-19) remains unclear.

Methods: In a matched cohort study, we evaluated the risk of COVID-19 infection and severe COVID-19 disease in individuals with DS and their matched counterparts in a pre-COVID-19 vaccination period at Kaiser Permanente Southern California. Multivariable Cox proportion hazard regression was used to investigate associations between DS and risk of COVID-19 infection and severe COVID-19 disease.

Results: Our cohort included 2541 individuals with DS and 10 164 without DS matched on age, sex, and race/ethnicity (51.6% female, 53.3% Hispanic, median age 25 years [interquartile range, 14-38]). Although the rate of COVID-19 infection in individuals with DS was 32% lower than their matched counterparts (adjusted hazard ratio [aHR], 0.68; 95% confidence interval [CI], .56-.83), the rate of severe COVID-19 disease was 6-fold higher (aHR, 6.14; 95% CI, 1.87-20.16).

Conclusions: Although the risk of COVID-19 infection is lower, the risk of severe disease is higher in individuals with DS compared with their matched counterparts. Better infection monitoring, early treatment, and promotion of vaccine for COVID-19 are warranted for DS populations.

Keywords: COVID-19; COVID-19 death; COVID-19 hospitalization; down syndrome.

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Conflict of interest statement

Potential conflicts of interest. J. H. K. has received funding from Moderna and GlaxoSmithKline unrelated to this manuscript. M. J. L. has received funding for Advisory Board activities related to coronavirus disease 2019 from AstraZeneca and Moderna, and he received funding related to clinical trials from Moderna, Novavax, and Johnson & Johnson unrelated to this manuscript. Y. L. has received funding from GlaxoSmithKline, Seqirus, Moderna, and Pfizer unrelated to this manuscript. A. F. has received funding from Moderna, GlaxoSmithKline, Gilead, and Pfizer unrelated to this manuscript. H.-F. T. has received funding from Moderna and GlaxoSmithKline, unrelated to this manuscript, and serves on advisory boards for Janssen and Pfizer. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Figures

Figure 1.
Figure 1.
Cumulative incidence estimates of coronavirus disease 2019 infection by Down syndrome status, Kaiser Permanente Southern California, March 1, 2020–December 31, 2020.
Figure 2.
Figure 2.
Cumulative incidence estimates of coronavirus disease 2019 hospitalization by Down syndrome status, Kaiser Permanente Southern California, March 1, 2020–December 31, 2020.
Figure 3.
Figure 3.
Cumulative incidence estimates of coronavirus disease 2019 hospitalization death by Down syndrome status, Kaiser Permanente Southern California, March 1, 2020–December 31, 2020.
See this image and copyright information in PMC

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References

    1. Rafii MS, Kleschevnikov AM, Sawa M, Mobley WC. Down syndrome. Handb Clin Neurol 2019; 167:321–36. doi:10.1016/B978-0-12-804766-8.00017-0. - DOI - PubMed
    1. Plaiasu V. Down syndrome – genetics and cardiogenetics. Maedica (Bucur) 2017; 12:208–13. - PMC - PubMed
    1. Centers for Disease Control and Prevention . Data and statistics on Down syndrome. Available at: https://www.cdc.gov/ncbddd/birthdefects/downsyndrome/data.html. Accessed 3 December 2021.
    1. Shin M, Besser LM, Kucik JE, Lu C, Siffel C, Correa A. Prevalence of Down syndrome among children and adolescents in 10 regions of the United States. Pediatrics 2009; 124:1565–71. doi:10.1542/peds.2009-0745. - DOI - PubMed
    1. de Graaf G, Buckley F, Skotko BG. Estimation of the number of people with Down syndrome in the United States. Genet Med 2017; 19:439–47. doi:10.1038/gim.2016.127. - DOI - PubMed

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