Enhancing understanding of SARS-CoV-2 infection among individuals with Down syndrome: An integrative review

• Published in: São Paulo medical journal Vol. 142; no. 2; p. e2023015
• Main Authors: Silva, Maria Vitoria Gomes da, Pereira, Laura Resende Guimarães, Avó, Lucimar Retto da Silva de, Germano, Carla Maria Ramos, Melo, Débora Gusmão
• Format: Journal Article
• Language: English; Portuguese
• Published: Associação Paulista de Medicina - APM 01.01.2024; Associação Paulista de Medicina
• Subjects: Coronavirus disease 2019; COVID-19; Cytokine storm in coronavirus disease 2019; Down syndrome; Down syndrome comorbidities; Integrative review; MEDICINE, GENERAL & INTERNAL; Original; Outcomes of coronavirus disease 2019 in individuals with Down syndrome; SARS-CoV-2; Systematic review [publication type]; Trisomy 21; COVID-19; Trisomy 21; SARS-CoV-2; Coronavirus disease 2019; Cytokine storm in coronavirus disease 2019; Integrative review; Systematic review [publication type]; Down syndrome comorbidities; Down syndrome; Outcomes of coronavirus disease 2019 in individuals with Down syndrome
• ISSN: 1516-3180; 1806-9460; 1806-9460
• DOI: 10.1590/1516-3180.2023.0015.r1.230523

BACKGROUNDDown syndrome (DS) is a non-rare genetic condition that affects approximately 1 in every 800 live births worldwide. Further, it is associated with comorbidities, anatomical alterations of the respiratory tract, and immunological dysfunctions that make individuals more susceptible to respiratory infections. OBJECTIVETo systematize the current scientific knowledge about the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among individuals with DS. DESIGN AND SETTINGThis integrative review was conducted at the Universidade Federal de São Carlos, São Paulo, Brazil. METHODSThis review was conducted in the following databases: the Virtual Health Library (Biblioteca Virtual em Saúde, BVS), PubMed, and Web of Science, using MeSH descriptors. The search included English or Portuguese studies published between January 1, 2020, and October 14, 2022. RESULTSA total of 55 articles from 24 countries were selected, comprising 21 case-control or cohort studies, 23 case reports or series, and 11 narrative reviews or opinion studies. The articles were grouped into five categories: previous comorbidities, coronavirus disease 2019 (COVID-19) clinical features and evolution, cytokine storm and interleukins, living in institutions as a risk factor, and behavioral actions as a protective factor against SARS-CoV-2 infection. CONCLUSIONIndividuals with DS are more susceptible to COVID-19 infection due to variables such as previous comorbidities, immunological factors, and their habitable environments. These aspects confer a higher risk of infection and an unfavorable clinical course. The precise pathways involved in the pathophysiology of COVID-19 in individuals with DS are not clear, thus requiring further studies. SYSTEMATIC REVIEW REGISTRATIONThe Open Science Framework registered the research protocol (https://osf.io/jyb97/).