Mortality from Covi-19 among people with Down syndrome could be up to ten times higher than that of the general population. This is what emerges from a study by the Higher Institute of Health which, together with the Catholic University and  Campus of Rome , analyzed 3,438 graphs drawn from February 22 to June 11 , identifying 16 deaths in subjects suffering from Down syndrome.

The research, published in the American Journal of Medical Genetics , is in line with the conclusions of another retrospective study conducted in the United States of hospitalized patients with Covid-19, which described a nine-fold increase in the expected percentage of patients with the syndrome of Downs hospitalized than the general population.

Over one hundred Down syndrome victims as of June 11 – “The prevalence of people with Down syndrome in our sample was 0.5% (16 individuals). This leads to an estimated 100-130 Down syndrome individuals per coronavirus in Italy until June 11. The prevalence of Down syndrome in the general Italian population is about 0.05%, suggesting that the mortality from Covid-19 in this group could be up to ten times higher than the general population ” , explains Graziano Onder, director of the Department of Cardiovascular, Endocrine-Metabolic and Aging Diseases of the ISS.

These patients “are more susceptible to infections, experience premature aging of multiple organs and systems, develop a broad spectrum of comorbidities including endocrinopathies, neurological, rheumatic, musculoskeletal diseases,” continues Onder. In addition, they “often have various anatomical abnormalities of the upper airways that increase the likelihood of obstruction, a condition that can predispose to pulmonary hypertension, which in turn can increase the severity of Covid-19 infection”.

“Access to the vaccine must be a priority” – In summary, adults with Down syndrome “represent a fragile population vulnerable to infections and therefore to be protected with extreme care in this epidemic phase”, says Emanuele Rocco Villani, PhD student research in Aging Sciences at the Catholic University and first author of the research. People with Down syndrome therefore fall into the segment of the population for which access to the coronavirus vaccine “must be a priority, when it is finally available”.

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Data and percentages – Individuals with Downs Syndrome surveyed were younger than those without DS (52 versus 78 years), while the sex distribution was similar (38% women and 33% men). Autoimmune diseases such as Hashimoto’s thyroiditis and psoriasis (44% versus 4%), obesity (38% versus 11%) and dementia (38% versus 16%) were significantly more prevalent in individuals with down syndrome.

Risk factors and superinfections – These conditions are known risk factors, as they are associated with a pro-inflammatory state, which appears to play a role in the onset of serious complications related to Covid-19. All 16 subjects also developed acute respiratory distress syndrome as a complication. Bacterial superinfections, such as bloodstream infections (sepsis) and bacterial pneumonia, were also more common among Downs who died from Covid-19 than in the general population (31% versus 13%). This is in line with the observation that individuals with DS have a greater susceptibility to infections due to the presence of immune deficiencies.

Dementia – The 16 patients examined also had a high prevalence of dementia, which is consistent with what is observed in the population with DS, in which progressive cognitive impairment can occur starting from the age of 45, reaching an overall prevalence of dementia up to 68-80% at 65 years. This is also in line with the observation that the characteristics of aging typically occur earlier than the general population and primarily involve the brain and immune system. The average age of death in subjects with Down syndrome was estimated at 60 years.