Abstract
Adults with Down Syndrome (DS) are at higher risk for severe outcomes of coronavirus disease 2019 (COVID-19) than the general population, but evidence is required to understand the risks for children with DS, which is necessary to inform COVID-19 shielding advice and vaccination priorities. We aimed to determine the epidemiological and clinical characteristics of COVID-19 in children with DS. Using data from an international survey obtained from a range of countries and control data from the United States, we compared the prevalence of symptoms and medical complications and risk factors for severe outcomes between DS and non-DS paediatric populations with COVID-19. Hospitalised COVID-19 patients <18 years with DS had a higher incidence of respiratory symptoms, fever, and several medical complications from COVID-19 than control patients without DS <18 years. Older age, obesity, and epilepsy were significant risk factors for hospitalisation among paediatric COVID-19 patients with DS, and age and thyroid disorder were significant risk factors for acute respiratory distress syndrome. Mortality rates were low in all paediatric COVID-19 patients (with and without DS), contrasting with previous findings in adults with DS (who exhibit higher mortality than those without DS). Children with DS are at increased risk for more severe presentations of COVID-19. Efforts should be made to ensure the comprehensive and early detection of COVID-19 in this population and to identify children with DS who present comorbidities that pose a risk for a severe course of COVID-19. Our results emphasize the importance of vaccinating children with DS as soon as they become eligible.
Original language | English |
---|---|
Article number | 5125 |
Journal | Journal of Clinical Medicine |
Volume | 10 |
Issue number | 21 |
Early online date | 31 Oct 2021 |
DOIs | |
Publication status | Published - 1 Nov 2021 |
Keywords
- COVID-19
- Down Syndrome
- Paediatrics
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In: Journal of Clinical Medicine, Vol. 10, No. 21, 5125, 01.11.2021.
Research output: Contribution to journal › Article › peer-review
TY - JOUR
T1 - Covid-19 in children with down syndrome
T2 - Data from the trisomy 21 research society survey
AU - MBBS FRCPCH DM on behalf of The Trisomy 21 Research Society COVID-19 Initiative Study Group
AU - Emes, David
AU - Hüls, Anke
AU - Baumer, Nicole
AU - Dierssen, Mara
AU - Puri, Shiela
AU - Russell, Lauren
AU - Sherman, Stephanie L.
AU - Strydom, Andre
AU - Bargagna, Stefania
AU - Brandão, Ana Cláudia
AU - Costa, Alberto C.S.
AU - Feany, Patrick T.
AU - Chicoine, Brian Allen
AU - Ghosh, Sujay
AU - Rebillat, Anne Sophie
AU - Sgandurra, Giuseppina
AU - Valentini, Diletta
AU - Rohrer, Tilman R.
AU - Levin, Johannes
AU - Lakhanpaul, Monica
N1 - Funding Information: This work is supported by grants from the following bodies: Down Syndrome Affiliates in Action, Down Syndrome Medical Interest Group-USA, GiGi?s Playhouse, Jerome Lejeune Foundation, LuMind IDSC Foundation, The Matthew Foundation, National Down Syndrome Society, National Task Group on Intellectual Disabilities and Dementia Practices. AH is supported by the HERCULES Center (NIEHS P30ES019776) and the LuMind IDSC Foundation. The REDCap survey and database management system at Emory University was supported by Library Information Technology Services grant support (UL1 TR000424). ACSC is supported by the Alana USA Foundation, Awakening Angels Foundation, and the Infectious Diseases Society of America (IDSA). MD is supported by the Centre for Genomic Regulation Severo Ochoa excellence grant, the CIBER of Rare Diseases, and DURSI 2017SGR595, and acknowledges the Spanish Ministry of Science, Innovation and Universities (MSIU) to the EMBL partnership, the Centro de Excelencia Severo Ochoa and CERCA (GenCat). AS is supported by the MRC (MR/S011277/1; MR/S005145/1; MR/R024901/1), Lumind IDSC, The LeJeune Foundation and the European Commission (H2020 SC1 Gene overdosage and comorbidities during the early lifetime in Down Syndrome GO-DS21-848077). ML was supported by the National Institute for Health Research (NIHR) Biomedical Research Centre based at UCL Great Ormond Street Institute of Child Health/Great Ormond Street Hospital NHS Foundation Trust). The Research Programme on Biomedical Informatics (GRIB) is a member of the Spanish National Bioinformatics Institute (INB), funded by ISCIII and EDER (PT17/0009/0014). The DCEXS is a ?Unidad de Excelencia Mar?a de Maeztu?, funded by the AEI (CEX2018-000782-M). The GRIB is also supported by the Ag?ncia de Gesti? d?Ajuts Universitaris i de Recerca (AGAUR), Generalitat de Catalunya (2017 SGR 00519). This study was also supported by the Fondo de Investigaciones Sanitario (FIS), Instituto de Salud Carlos III (PI18/00335 to MCI, PI14/01126 and PI17/01019 to JF), partly jointly funded by Fondo Europeo de Desarrollo Regional, Uni?n Europea, Una manera de hacer Europa; the J?r?me Lejeune Foundation (No. 1319 Cycle 2019B to MCI); the National Institutes of Health (NIA grants 1R01AG056850-01A1; R21AG056974 and R01AG061566 to JF); Departament de Salut de la Generalitat de Catalunya, Pla Estrat?gic de Recerca i Innovaci? en Salut (SLT006/17/00119 to JF); and Fundaci? La Marat? de TV3 (20141210 to JF). The Trisomy 21 Research Society COVID-19 Initiative developed the survey, with the financial and dissemination support of Down Syndrome Affiliates in Action (DSAIA), Down Syndrome Medical Interest Group-USA (DSMIG-USA), GiGi?s Playhouse, Jerome Lejeune Foundation, LuMind IDSC Foundation, The Matthew Foundation, National Down Syndrome Society (NDSS), and the National Task Group on Intellectual Disabilities and Dementia Practices (NTG). These and other international Down Syndrome organisations are members of the T21RS COVID-19 stakeholders advisory group, which provided advice to inform the design of the survey questions and interpretation of results, including the Global Down Syndrome Foundation (USA), DSA (UK), DSMIG (UK), DSMIG (USA), DSRF-UK, DSi, DSE international, Trisomie21-France, Down Espa?a, National Down Syndrome Congress (NDSC), Down Madrid, Fundaci? Catalana S?ndrome de Down (Spain), EDSA, Royal College of Psychiatrists, CoorDown (Italy), Associazione Italiana Persone Down (AIPD; Italy), AFRT (France), Fundaci?n Iberoamericana Down 21 (Spain), FIADOWN (Latin Amer-ica), Federa??o Brasileira das Associa??es de S?ndrome de Down (Brazil) and the European Down Syndrome Association. We acknowledge the contribution of DS-Connect? (The Down Syndrome Registry), which is supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), NIH for the dissemination of the T21RS survey. We also wish to thank the many families and clinicians who contributed to the survey. Funding Information: Acknowledgments: The Trisomy 21 Research Society COVID-19 Initiative developed the survey, with the financial and dissemination support of Down Syndrome Affiliates in Action (DSAIA), Down Syndrome Medical Interest Group-USA (DSMIG-USA), GiGi’s Playhouse, Jerome Lejeune Foundation, LuMind IDSC Foundation, The Matthew Foundation, National Down Syndrome Society (NDSS), and the National Task Group on Intellectual Disabilities and Dementia Practices (NTG). These and other international Down syndrome organisations are members of the T21RS COVID-19 stakeholders advisory group, which provided advice to inform the design of the survey questions and interpretation of results, including the Global Down Syndrome Foundation (USA), DSA (UK), DSMIG (UK), DSMIG (USA), DSRF-UK, DSi, DSE international, Trisomie21-France, Down España, National Down Syndrome Congress (NDSC), Down Madrid, Fundació Catalana Síndrome de Down (Spain), EDSA, Royal College of Psychiatrists, CoorDown (Italy), Associazione Italiana Persone Down (AIPD; Italy), AFRT (France), Fundación Iberoamericana Down 21 (Spain), FIADOWN (Latin America), Federação Brasileira das Associações de Síndrome de Down (Brazil) and the European Down Syndrome Association. We acknowledge the contribution of DS-Connect® (The Down Syndrome Registry), which is supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), NIH for the dissemination of the T21RS survey. We also wish to thank the many families and clinicians who contributed to the survey. 13 of 19 Funding Information: Funding: This work is supported by grants from the following bodies: Down Syndrome Affiliates in Action, Down Syndrome Medical Interest Group-USA, GiGi’s Playhouse, Jerome Lejeune Foundation, LuMind IDSC Foundation, The Matthew Foundation, National Down Syndrome Society, National Task Group on Intellectual Disabilities and Dementia Practices. AH is supported by the HERCULES Center (NIEHS P30ES019776) and the LuMind IDSC Foundation. The REDCap survey and database management system at Emory University was supported by Library Information Technology Services grant support (UL1 TR000424). ACSC is supported by the Alana USA Foundation, Awakening Angels Foundation, and the Infectious Diseases Society of America (IDSA). MD is supported by the Centre for Genomic Regulation Severo Ochoa excellence grant, the CIBER of Rare Diseases, and DURSI 2017SGR595, and acknowledges the Spanish Ministry of Science, Innovation and Universities (MSIU) to the EMBL partnership, the Centro de Excelencia Severo Ochoa and CERCA (GenCat). AS is supported by the MRC (MR/S011277/1; MR/S005145/1; MR/R024901/1), Lumind IDSC, The LeJeune Foundation and the European Commission (H2020 SC1 Gene overdosage and comorbidities during the early lifetime in Down Syndrome GO-DS21-848077). ML was supported by the National Institute for Health Research (NIHR) Biomedical Research Centre based at UCL Great Ormond Street Institute of Child Health/Great Ormond Street Hospital NHS Foundation Trust). The Research Programme on Biomedical Informatics (GRIB) is a member of the Spanish National Bioinformatics Institute (INB), funded by ISCIII and EDER (PT17/0009/0014). The DCEXS is a “Unidad de Excelencia María de Maeztu”, funded by the AEI (CEX2018-000782-M). The GRIB is also supported by the Agència de Gestió d’Ajuts Universitaris i de Recerca (AGAUR), Generalitat de Catalunya (2017 SGR 00519). This study was also supported by the Fondo de Investigaciones Sanitario (FIS), Instituto de Salud Carlos III (PI18/00335 to MCI, PI14/01126 and PI17/01019 to JF), partly jointly funded by Fondo Europeo de Desarrollo Regional, Unión Europea, Una manera de hacer Europa; the Jérôme Lejeune Foundation (No. 1319 Cycle 2019B to MCI); the National Institutes of Health (NIA grants 1R01AG056850 - 01A1; R21AG056974 and R01AG061566 to JF); Departament de Salut de la Generalitat de Catalunya, Pla Estratègic de Recerca i Innovació en Salut (SLT006/17/00119 to JF); and Fundació La Marató de TV3 (20141210 to JF). Funding Information: Acknowledgments: The Trisomy 21 Research Society COVID-19 Initiative developed the survey, with the financial and dissemination support of Down Syndrome Affiliates in Action (DSAIA), Down Syndrome Medical Interest Group-USA (DSMIG-USA), GiGi’s Playhouse, Jerome Lejeune Foundation, LuMind IDSC Foundation, The Matthew Foundation, National Down Syndrome Society (NDSS), and the National Task Group on Intellectual Disabilities and Dementia Practices (NTG). These and other international Down Syndrome organisations are members of the T21RS COVID-19 stakeholders advisory group, which provided advice to inform the design of the survey questions and interpretation of results, including the Global Down Syndrome Foundation (USA), DSA (UK), DSMIG (UK), DSMIG (USA), DSRF-UK, DSi, DSE international, Trisomie21-France, Down España, National Down Syndrome Congress (NDSC), Down Madrid, Fundació Catalana Síndrome de Down (Spain), EDSA, Royal College of Psychiatrists, CoorDown (Italy), Associazione Italiana Persone Down (AIPD; Italy), AFRT (France), Fundación Iberoamericana Down 21 (Spain), FIADOWN (Latin America), Federação Brasileira das Associações de Síndrome de Down (Brazil) and the European Down Syndrome Association. We acknowledge the contribution of DS-Connect® (The Down Syndrome Registry), which is supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), NIH for the dissemination of the T21RS survey. We also wish to thank the many families and clinicians who contributed to the survey. Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2021/11/1
Y1 - 2021/11/1
N2 - Adults with Down Syndrome (DS) are at higher risk for severe outcomes of coronavirus disease 2019 (COVID-19) than the general population, but evidence is required to understand the risks for children with DS, which is necessary to inform COVID-19 shielding advice and vaccination priorities. We aimed to determine the epidemiological and clinical characteristics of COVID-19 in children with DS. Using data from an international survey obtained from a range of countries and control data from the United States, we compared the prevalence of symptoms and medical complications and risk factors for severe outcomes between DS and non-DS paediatric populations with COVID-19. Hospitalised COVID-19 patients <18 years with DS had a higher incidence of respiratory symptoms, fever, and several medical complications from COVID-19 than control patients without DS <18 years. Older age, obesity, and epilepsy were significant risk factors for hospitalisation among paediatric COVID-19 patients with DS, and age and thyroid disorder were significant risk factors for acute respiratory distress syndrome. Mortality rates were low in all paediatric COVID-19 patients (with and without DS), contrasting with previous findings in adults with DS (who exhibit higher mortality than those without DS). Children with DS are at increased risk for more severe presentations of COVID-19. Efforts should be made to ensure the comprehensive and early detection of COVID-19 in this population and to identify children with DS who present comorbidities that pose a risk for a severe course of COVID-19. Our results emphasize the importance of vaccinating children with DS as soon as they become eligible.
AB - Adults with Down Syndrome (DS) are at higher risk for severe outcomes of coronavirus disease 2019 (COVID-19) than the general population, but evidence is required to understand the risks for children with DS, which is necessary to inform COVID-19 shielding advice and vaccination priorities. We aimed to determine the epidemiological and clinical characteristics of COVID-19 in children with DS. Using data from an international survey obtained from a range of countries and control data from the United States, we compared the prevalence of symptoms and medical complications and risk factors for severe outcomes between DS and non-DS paediatric populations with COVID-19. Hospitalised COVID-19 patients <18 years with DS had a higher incidence of respiratory symptoms, fever, and several medical complications from COVID-19 than control patients without DS <18 years. Older age, obesity, and epilepsy were significant risk factors for hospitalisation among paediatric COVID-19 patients with DS, and age and thyroid disorder were significant risk factors for acute respiratory distress syndrome. Mortality rates were low in all paediatric COVID-19 patients (with and without DS), contrasting with previous findings in adults with DS (who exhibit higher mortality than those without DS). Children with DS are at increased risk for more severe presentations of COVID-19. Efforts should be made to ensure the comprehensive and early detection of COVID-19 in this population and to identify children with DS who present comorbidities that pose a risk for a severe course of COVID-19. Our results emphasize the importance of vaccinating children with DS as soon as they become eligible.
KW - COVID-19
KW - Down Syndrome
KW - Paediatrics
UR - http://www.scopus.com/inward/record.url?scp=85118216662&partnerID=8YFLogxK
U2 - 10.3390/jcm10215125
DO - 10.3390/jcm10215125
M3 - Article
AN - SCOPUS:85118216662
SN - 2077-0383
VL - 10
JO - Journal of Clinical Medicine
JF - Journal of Clinical Medicine
IS - 21
M1 - 5125
ER -