What is it about?
Down syndrome (DS) is a non-rare genetic disorder associated with intellectual incapacity and several comorbidities, including anatomical and immunological changes, that make these people more vulnerable to recurrent respiratory infections and their adverse outcomes. The COVID-19 pandemic promoted interest in the debate about the natural history of the disease and the most effective approaches to giving DS patients access to quality medical care. We conducted an integrative review of the literature, which included 55 publications published between January 2020 and October 2022 in Portuguese and English, to determine what was known about SARS-CoV-2 infection in the DS population. Our results showed that the exact pathophysiological mechanisms of COVID-19 in people with DS have not yet been completely clarified. However, they revealed that certain factors predispose to the greater severity of the infection, highlighting some comorbidities such as dementia, heart disease, obesity, sleep apnea, and thyroid disorders. Furthermore, there is a dysfunctional immune response related to changes in the inflammatory response to infection, clinical presentation, and outcomes. Other factors, such as living in institutional housing and having repetitive social behaviors, were also relevant for understanding the risk and protective factors for COVID-19.
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Why is it important?
Considering the results of our review, we confirmed that individuals with DS need special attention when they have COVID-19, requiring greater surveillance in the acute phase of the infection, especially considering the underlying diseases and factors of risk that these individuals may have. Our study also highlighted the need for future research with clinical and experimental studies to better understand specific characteristics related to the pathophysiology of SARS-CoV-2 infection in this population.
Perspectives
The current literature does not include clinical and randomized studies on SARS-CoV-2 infection in people with DS. By synthesizing the knowledge available in the literature, we broaden the perspective on the subject, supporting clinical practice and identifying gaps in knowledge.
Maria Vitoria Gomes da Silva
Federal University of São Carlos
Read the Original
This page is a summary of: Enhancing understanding of SARS-CoV-2 infection among individuals with Down syndrome: An integrative review, Sao Paulo Medical Journal, January 2024, FapUNIFESP (SciELO),
DOI: 10.1590/1516-3180.2023.0015.r1.230523.
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