Should individuals with Down syndrome be considered high-risk during COVID-19? A review of the science and current evidence.

People with Down syndrome show signs of chronic immune dysregulation, including a higher prevalence of autoimmune disorders, increased rates of hospitalization during respiratory viral infections, and higher mortality rates from pneumonia and sepsis. At the molecular and cellular levels, they show markers of chronic autoinflammation, including interferon hyperactivity, elevated levels of many inflammatory cytokines and chemokines, and changes in diverse immune cell types reminiscent of inflammatory conditions observed in the general population. However, the impact of this immune dysregulation in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and CoV disease of 2019 (COVID-19) remains unknown. This “Perspective” outlines why individuals with Down syndrome should be considered an at-risk population for severe COVID-19. Specifically, the immune dysregulation caused by trisomy 21 may result in an exacerbated cytokine release syndrome relative to that observed in the typical euploid population, thus justifying additional monitoring and specialized care for this vulnerable population.

Check out the full publication from Cell Reports Medicine.

Down syndrome and COVID-19: A Perfect Storm? Espinosa JM. Cell Rep Med. Volume 1, Issue 2, 100019, May 19, 2020. DOI:https://doi.org/10.1016/j.xcrm.2020.100019.