Down Syndrome and COVID-19: A Perfect Storm?
Down Syndrome and COVID-19: A Perfect Storm?
复制标题
DOI：
10.1016/j.xcrm.2020.100019
复制
发表时间：
2020-05-19
影响因子：
14.3
通讯作者：
Espinosa, Joaquin M.
中科院分区：
文献类型：
--
作者：
Espinosa, Joaquin M.
唐氏综合征患者表现出慢性免疫失调的迹象，包括自身免疫性疾病的患病率较高，呼吸道病毒感染期间住院率增加，以及肺炎和败血症的死亡率较高。在分子和细胞水平上，它们显示了慢性自身炎症的标志物，包括干扰素过度活跃，许多炎性细胞因子和趋化因子水平升高，以及各种免疫细胞类型的变化，这些变化让人联想到在一般人群中观察到的炎症状况。然而，这种免疫失调在严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）感染和2019年冠状病毒病（COVID-19）中的影响仍然未知。这一观点概述了为什么唐氏综合征患者应被视为严重COVID-19的高危人群。具体而言，由21三体引起的免疫失调可能导致相对于整倍体人群中观察到的细胞因子释放综合征加剧，从而证明对该脆弱人群进行额外监测和专门护理是合理的。
People with Down syndrome show signs of chronic immune dysregulation, including a higher prevalence of autoimmune disorders, increased rates of hospitalization during respiratory viral infections, and higher mortality rates from pneumonia and sepsis. At the molecular and cellular levels, they show markers of chronic autoinflammation, including interferon hyperactivity, elevated levels of many inflammatory cytokines and chemokines, and changes in diverse immune cell types reminiscent of inflammatory conditions observed in the general population. However, the impact of this immune dysregulation in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and CoV disease of 2019 (COVID-19) remains unknown. This Perspective outlines why individuals with Down syndrome should be considered an at-risk population for severe COVID-19. Specifically, the immune dysregulation caused by trisomy 21 may result in an exacerbated cytokine release syndrome relative to that observed in the euploid population, thus justifying additional monitoring and specialized care for this vulnerable population.