Down Syndrome patients with COVID-19 pneumonia: A high-risk category for unfavourable outcome

Graphical abstract
Highlights • Pro-inflammatory factors play a central role in COVID-19 severity and mortality. • Down Syndrome is characterized by immune dysregulation and respiratory infections. • Down Syndrome patients with COVID-19 are at high-risk for unfavourable outcome.
We report two cases of COronaVIrus Disease-19 in patients with Down Syndrome and describe the identification, diagnosis, clinical course, and management of the infection. Down Syndrome, which is caused by trisomy 21, is characterized by immune dysregulation, anatomical differences in the upper respiratory tract, and higher rate of comorbidities. All these risk factors can contribute to more severe clinical presentations of COVID-19. It is essential to raise awareness of the clinical relevance of SARS-COV-2 infection in DS patients, as well in other most vulnerable patients in order to improve their management and treatment and to candidate these individuals for vaccination, once available.