COVID-19 in Children with Down Syndrome: Data from the Trisomy 21 Research Society Survey

  1. David Emes
  2. Anke Hüls
  3. Nicole Baumer
  4. Mara Dierssen
  5. Shiela Puri
  6. Lauren Russell
  7. Stephanie Sherman
  8. Andre Strydom
  9. Stefania Bargagna
  10. Ana Brandão
  11. Alberto Costa
  12. Patrick Feany
  13. Brian Chicoine
  14. Sujay Ghosh
  15. Anne-Sophie Rebillat
  16. Giuseppina Sgandurra
  17. Diletta Valentini
  18. Tilman Rohrer
  19. Johannes Levin
  20. Monica Lakhanpaul
  21. on behalf of the Trisomy 21 Research Society COVID-19 Initiative Study Group

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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.

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  1. Version published to 10.3390/jcm10215125
  2. ScreenIT

    SciScore for 10.1101/2021.06.25.21259525: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsConsent: The study was performed according to the Declaration of Helsinki and national guidelines and regulations for data privacy and all participants who completed the questionnaires provided informed consent.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    4.3 Limitations and Areas for Future Research: One notable limitation of our study is that control data were only available from hospitalised paediatric patients in the US, entailing a comparison of patients from LMICs to controls in HICs. Furthermore, the age distribution of the children with and without Down syndrome differed and as we had only access to the summary statistics, we could not adjust our association analyses for age. Subsequent international studies should explore comparison with controls from a range of countries when suitable data become available. In addition, most of our cases from LMICs were from India (137/202), making generalisation of findings to other LMICs difficult. When reporting the ethnicity of patients, we used WHO categories, but the way in which ethnicity was reported varied among countries. We had limited data concerning about black, indigenous populations, Asian and other children representing minority ethnic groups in HICs, and may have overlooked risks unique to those groups. More attention should also be paid to non-hospitalised and asymptomatic paediatric COVID-19 patients with DS, who could experience long-term effects of COVID-19. Thus, future research should aim to determine if the symptoms of non-hospitalised children with DS differ from those of the general paediatric population. Because our control data pertained to hospitalised patients only, this analysis lay beyond the scope of this investigation. Future research must also inves...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2021.06.25.21259525v1 on medRxiv