Susceptibility to COVID-19 Diagnosis in People with Down Syndrome Compared to the General Population: Matched-Cohort Study Using Primary Care Electronic Records in the UK

J Gen Intern Med. 2022 Jun;37(8):2009-2015. doi: 10.1007/s11606-022-07420-9. Epub 2022 Apr 6.

Abstract

Background: During the COVID-19 pandemic, people with Down syndrome (DS) have experienced a more severe disease course and higher mortality rates than the general population. It is not yet known whether people with DS are more susceptible to being diagnosed with COVID-19.

Objective: To explore whether DS is associated with increased susceptibility to COVID-19.

Design: Matched-cohort study design using anonymised primary care electronic health records from the May 2021 release of Clinical Practice Research Datalink (CPRD) Aurum.

Setting: Electronic health records from approximately 1400 general practices (GPs) in England.

Participants: 8854 people with DS and 34,724 controls matched for age, gender and GP who were registered on or after the 29th January 2020.

Measurements: The primary outcome was COVID-19 diagnosis between January 2020 and May 2021. Conditional logistic regression models were fitted to estimate associations between DS and COVID-19 diagnosis, adjusting for comorbidities.

Results: Compared to controls, people with DS were more likely to be diagnosed with COVID-19 (7.4% vs 5.6%, p ≤ 0.001, odds ratio (OR) = 1.35; 95% CI = 1.23-1.48). There was a significant interaction between people with DS and a chronic respiratory disease diagnosis excluding asthma and increased odds of a COVID-19 diagnosis (OR = 1.71; 95% CI = 1.20-2.43), whilst adjusting for a number of comorbidities.

Conclusion: Individuals with DS are at increased risk for contracting COVID-19. Those with underlying lung conditions are particularly vulnerable during viral pandemics and should be prioritised for vaccinations.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Asthma* / diagnosis
  • Asthma* / epidemiology
  • COVID-19 Testing
  • COVID-19* / diagnosis
  • COVID-19* / epidemiology
  • Cohort Studies
  • Down Syndrome* / diagnosis
  • Down Syndrome* / epidemiology
  • Electronics
  • England / epidemiology
  • Humans
  • Pandemics
  • Primary Health Care