Article Text

Download PDFPDF
High case fatality rate in individuals with Down syndrome and COVID-19 in Brazil: a two-year report
  1. Matheus Negri Boschiero,
  2. José Roberto Lutti Filho,
  3. Manoela Marques Ortega,
  4. Fernando Augusto Lima Marson
  1. Health Science, Universidade São Francisco, Braganca Paulista, São Paulo, Brazil
  1. Correspondence to Dr Fernando Augusto Lima Marson, Health Science, Universidade São Francisco, Braganca Paulista, SP 12916-900, Brazil; fernandolimamarson{at}

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Few studies have evaluated the outcomes of COVID-19 in individuals with Down syndrome (DS), which indicated a higher association between DS and longer hospitalisation time, COVID-19 severity and mortality rate.1–8 From these studies, four out of five have presented a small cohort with less than 40 individuals with DS and COVID-19,1–4 except one report that has included 750 individuals.5 Thus, the real effect of COVID-19 in individuals with DS is not entirely clear, and it would be important to know it, mainly for its importance as a risk factor for death. In this context, we compared the case fatality rate, the need for mechanical ventilation (MV) and the need for intensive care unit (ICU) hospitalisation between hospitalised individuals with DS infected by SARS-CoV-2 and hospitalised individuals without DS also infected by SARS-CoV-2, using a Brazilian public dataset.

We retrieved the data from the Brazilian Ministry of Health platform ( that included epidemiological data for severe acute respiratory infection (SARI) in Brazil, including the cases of severe acute respiratory syndrome (SARS) due to the COVID-19. Among a total of 3 117 562 individuals with SARI, representing 2 years of COVID-19 pandemic in Brazil, 5152 individuals were identified as individuals with DS and were positive for SARS-CoV-2 RT-PCR (G1). In addition, the second group of individuals was enrolled, including individuals without DS and also infected by SARS-CoV-2 (G2). For the last group, the exclusion criteria were based on the absence of DS. For both groups, we excluded the individuals without confirmation of the SARS-CoV-2 infection or individuals without the information for outcome (death or clinical recovery) and comorbidities status to prove the DS diagnosis. Thus, it was set in two groups of study, those hospitalised individuals without DS (G2) and those hospitalised individuals with DS (G1). Both groups were positive for RT-PCR …

View Full Text


  • Handling editor Tahir S Pillay.

  • MNB, JRLF and FALM contributed equally.

  • Contributors All authors have approved the manuscript and agreed with its submission to the journal. Also, all authors wrote and revised the manuscript.

  • Funding (MNB) Fundação de Amparo à Pesquisa do Estado de São Paulo (The São Paulo Research Foundation; FAPESP: #2021/05810-7).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.