Introduction:
The most common chromosomal cause of developmental disabilities is Down
syndrome (DS), caused by a trisomy of specific gene 21. It has been
linked to several co-existing health disorders and immunological
dysfunction, all of which can influence the disease symptoms and
increase the risk of life-threatening disease from exposure to the
emerging severe acute respiratory syndrome coronavirus 2. (SARS-CoV-2)
(1). COVID-19 is primarily a respiratory infection, although it can
progress to a severe illness with multi-organ failure and mortality (1).
Immune dysregulation in people with Down syndrome makes them more
susceptible to viral diseases, while structural airway characteristics
make them more susceptible to respiratory infections (2-4). Respiratory
diseases are a leading cause of death in people with Down syndrome (5,
6). People with the Down syndrome condition appear to be especially
vulnerable to COVID-19, with a four-fold increased risk of
COVID-19-related hospitalization and an estimated three- to ten-fold
more significant risk of COVID-19-related fatality (7-9). Several
genetic variants in coordinating immune responses are found on
chromosome 21 in Down syndrome, and their amplification causes an
increased immune system. Four interferons (IFN) receptors, which
function as a sensor, operate for the cytokines interleukin (IL)-10,
IL-22, and IL-26, are the primary immunity stabilizers encoded on
chromosome 21 (10). Additionally, people with Down syndrome have
immunological and non-immune cells vulnerable to IFN activation (11). In
people with Down syndrome, persistent immunological dysregulation is
frequent. As a result, they are more susceptible to infections,
particularly bacterial and virus-related pneumonia (12). T cell lineages
in adults with Down syndrome have been demonstrated in previous research
to display significant evidence of heightened activity even in the
absence of any evident infections, a trait presumed to be driven by
persistent IFN hyperactivity (13). As a result, patients with Down
syndrome have a strong IFN response, which is vital for elevating
antiviral responses and triggering and magnifying the cytokine storm (3,
14). It is unclear how people with Down syndrome may react to the
illness. Espinosa provided solid evidence in a recent analysis that
people with trisomy 21 have a higher chance of getting more severe
symptoms and have higher hospitalization rates, intensive care
admission, secondary bacterial infections, and mortality from SARS-CoV-2
infection (3). We address adults’ patients with Down syndrome by
reporting the results of COVID-19 who was hospitalized in a private
hospital in Chittagong, Bangladesh.