Differences in clinical presentation, severity, and treatment of COVID-19 among individuals with Down syndrome from India and high-income countries: Data from the Trisomy 21 Research Society survey

Halder Pinku; Anke Hüls; Patrick T Feany; Nicole Baumer; Mara Dierssen; Stefania Bargagna; Alberto Cs Costa; Brian A Chicoine; Anne-Sophie Rebillat; Giuseppina Sgandurra; Diletta Valentini; R Tilman Rohrer; Johannes Levin; Monica Lakhanpaul; Angelo Carfì; Stephanie L Sherman; Andre Strydom; Sujay Ghosh; Trisomy 21 Research Society COVID-19 Initiative Study Group

doi:10.7189/jogh.12.05035

Differences in clinical presentation, severity, and treatment of COVID-19 among individuals with Down syndrome from India and high-income countries: Data from the Trisomy 21 Research Society survey

J Glob Health. 2022 Aug 8:12:05035. doi: 10.7189/jogh.12.05035.

Authors

Halder Pinku^#¹, Anke Hüls^#^{2

3}, Patrick T Feany², Nicole Baumer⁴, Mara Dierssen^{5

6

7}, Stefania Bargagna⁸, Alberto Cs Costa⁹, Brian A Chicoine¹⁰, Anne-Sophie Rebillat¹¹, Giuseppina Sgandurra^{1

3

12}, Diletta Valentini¹³, R Tilman Rohrer¹⁴, Johannes Levin^{15

16

17}, Monica Lakhanpaul^{18

19

20}, Angelo Carfì²¹, Stephanie L Sherman²², Andre Strydom^{23

24}, Sujay Ghosh¹; Trisomy 21 Research Society COVID-19 Initiative Study Group

Affiliations

¹ Cytogenetics and Genomics Research Unit, Department of Zoology, University of Calcutta, Kolkata, West Bengal, India.
² Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
³ Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
⁴ Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
⁵ Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain.
⁶ Universitat Pompeu Fabra (UPF), Barcelona, Spain.
⁷ Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Spain.
⁸ Fondazione Stella Maris IRCCS, Pisa, Italy.
⁹ Department of Psychiatry, School of Medicine, and Department of Macromolecular. Science and Engineering, Case Western Reserve University, Cleveland, Ohio, USA.
¹⁰ Advocate Medical Group Adult Down Syndrome Center, Park Ridge, Illinois, USA.
¹¹ Institut Jérôme Lejeune, Paris, France.
¹² Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy.
¹³ Pediatric Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
¹⁴ Division of Pediatric Endocrinology, Saarland University Medical Center, Homburg/Saar, Germany.
¹⁵ Department of Neurology, Ludwig-Maximilians-Universität München, Munich, Germany.
¹⁶ German Center for Neurodegenerative Diseases, site Munich, Munich, Germany.
¹⁷ Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.
¹⁸ Department of Population Policy and Practice, UCL Great Ormond Street Institute of Child Health, University College London, UK.
¹⁹ Whittington NHS Trust, London, UK.
²⁰ Down Syndrome Medical Interest Group, London, UK.
²¹ Geriatric Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
²² Department of Human Genetics, School of Medicine, Emory University, Atlanta, Georgia, USA.
²³ Institute of Psychiatry, Psychology, and Neuroscience, Department of Forensic and Neuro-developmental Sciences, King's College London, London, UK.
²⁴ The London Down Syndrome (LonDownS) Consortium, London, UK.

^# Contributed equally.

Abstract

Background: People with Down syndrome (DS) are one of the highest risk groups for mortality associated with COVID-19, but outcomes may differ across countries due to different co-morbidity profiles, exposures, and societal practices, which could have implications for disease management. This study is designed to identify differences in clinical presentation, severity, and treatment of COVID-19 between India and several high-income countries (HICs).

Methods: We used data from an international survey to examine the differences in disease manifestation and management for COVID-19 patients with DS from India vs HIC. De-identified survey data collected from April 2020 to August 2021 were analysed.

Results: COVID-19 patients with DS from India were on average nine years younger than those from HICs. Comorbidities associated with a higher risk for severe COVID-19 were more frequent among the patients from India than from HICs. Hospitalizations were more frequent among patients from India as were COVID-19-related medical complications. Treatment strategies differed between India and HICs, with more frequent use of antibiotics in India. The average severity score of 3.31 was recorded for Indian DS in contrast to 2.3 for European and 2.04 for US cases.

Conclusions: Presentation and outcomes of COVID-19 among individuals with DS were more severe for patients from India than for those from HIC. Global efforts should especially target vaccination campaigns and other risk-reducing interventions for individuals with DS from low-income countries.

MeSH terms

COVID-19* / therapy
Developed Countries
Down Syndrome* / epidemiology
Down Syndrome* / therapy
Humans
Income
India / epidemiology

Abstract

MeSH terms

Grants and funding