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Down Syndrome Increases COVID Death Risk 10 Fold

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October 26, 2020 -- Adults with Down syndrome have a higher risk of being hospitalized with coronavirus and much higher risk of dying from coronavirus, researchers in the United Kingdom said.

“We estimated a 4-fold increased risk for COVID-19–related hospitalization and a 10-fold increased risk for COVID-19–related death in persons with Down syndrome,” said the study, published in the Annals of Internal Medicine.
The findings are significant because people with Down syndrome are generally not classified as being at a high-risk for coronavirus, like people with underlying conditions such as hypertension or diabetes.

“Down syndrome features on neither the UK shielding list nor the U.S. Centers for Disease Control and Prevention list of groups at ‘increased risk,’” said the study. “However, it is associated with immune dysfunction, congenital heart disease, and pulmonary pathology and, given its prevalence, may be a relevant, albeit unconfirmed, risk factor for severe COVID-19.”

Researchers, led by scientists from the University of Oxford, studied 8.26 million adults, including 4,053 diagnosed as having Down syndrome, from Jan. 24 to June 30.

Sixty-eight people with Down syndrome died during the study period -- 27 (39.7%) of coronavirus, 17 (25.0%) of pneumonia or pneumonitis, and 24 (35.3%) of other causes.

The study said 41,685 people without Down syndrome died -- 8,457 (20.3%) of COVID-19, 5,999 (14.4%) of pneumonia or pneumonitis, and 27,229 (65.3%) of other causes.

After adjusting for age, sex, ethnicity, body mass index, residency in a long-term care facility, and underlying conditions such as dementia or congenital heart disease, the researchers concluded the hazard ratio for COVID-19–associated death was 10.39 and the hazard ratio for hospitalization was 4.94.

Researchers offered a caveat about the figures.

“These estimated adjusted associations do not have a direct causal interpretation because some adjusted variables may lie on causal pathways, but they can inform policy and motivate further investigation. Participation in day care programs or immunologic deficits could be implicated, for example,” they wrote.

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Sources

Annals of Internal Medicine. “COVID-19 Mortality Risk in Down Syndrome: Results From a Cohort Study Of 8 Million Adults”

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