Multiple Organ Failure Associated with SARS-CoV-2 Infection in a Child with Down Syndrome: Is Trisomy 21 Associated with an Unfavourable Clinical Course?
Introduction. Down syndrome (DS) is one of the most frequent genomic disorders around the globe (∼1:700 births). During the COVID-19 pandemic, it has been recognized that children with DS are patients with a greater risk of presenting SARS-CoV-2 infection-related poor outcomes. Nonetheless, a few ca...
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Case Reports in Pediatrics |
| Online Access: | http://dx.doi.org/10.1155/2021/5893242 |
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| author | Perla Idalia Vazquez-Hernández Alan Cárdenas-Conejo Manuel Alejandro Catalán-Ruiz Karla Navar-Gallegos Emilio Zenteno-Salazar Jose Rafael-Parra-Bravo Ranferi Aragon-Nogales Maribel Ibarra-Sarlat Juan Carlos Núñez-Enríquez |
| author_facet | Perla Idalia Vazquez-Hernández Alan Cárdenas-Conejo Manuel Alejandro Catalán-Ruiz Karla Navar-Gallegos Emilio Zenteno-Salazar Jose Rafael-Parra-Bravo Ranferi Aragon-Nogales Maribel Ibarra-Sarlat Juan Carlos Núñez-Enríquez |
| author_sort | Perla Idalia Vazquez-Hernández |
| collection | DOAJ |
| description | Introduction. Down syndrome (DS) is one of the most frequent genomic disorders around the globe (∼1:700 births). During the COVID-19 pandemic, it has been recognized that children with DS are patients with a greater risk of presenting SARS-CoV-2 infection-related poor outcomes. Nonetheless, a few cases with DS and SARS-CoV-2 infection have been reported. Our aim is to describe the unfavorable clinical course of a child with DS infected with SARS-CoV-2 virus. Case. Female, 2 years old, karyotype 47,XX,+21[30], previously diagnosed with a cyanotic congenital heart disease (tricuspid atresia and infundibular pulmonary stenosis, type Ib) who started with diarrhea, developed shortness of breath, and cyanosis and was admitted to the hospital presenting low-oxygen saturation (33%) requiring invasive mechanical ventilation support. The patient tested positive for SARS-CoV-2 infection. During hospitalization, the patient presented hypotension, anuria, retarded capillary filling, and metabolic acidosis; management with vasoactive drugs was needed. Nonetheless, the patient developed respiratory and cardiac failure, acute renal injury (AKIN-III), and septic shock. After 24 days of hospitalization, the patient died. Conclusions. Multiple organ failure observed in the patient presented could be related to the triple gene dose of four interferon receptors (IFNAR1, IFNAR2, IFNGR2, and IL10RB) located at 21q22.11. Additionally, overexpression of TMPRSS2 at the pulmonary level, located also at 21q22.3, could be related with an increased susceptibility for the development of SARS-CoV-2 infection in DS patients. |
| format | Article |
| id | doaj-art-c9f1b558f4fb4d76a74b0b655d580b68 |
| institution | Kabale University |
| issn | 2090-6811 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Pediatrics |
| spelling | doaj-art-c9f1b558f4fb4d76a74b0b655d580b682025-02-03T06:46:24ZengWileyCase Reports in Pediatrics2090-68112021-01-01202110.1155/2021/5893242Multiple Organ Failure Associated with SARS-CoV-2 Infection in a Child with Down Syndrome: Is Trisomy 21 Associated with an Unfavourable Clinical Course?Perla Idalia Vazquez-Hernández0Alan Cárdenas-Conejo1Manuel Alejandro Catalán-Ruiz2Karla Navar-Gallegos3Emilio Zenteno-Salazar4Jose Rafael-Parra-Bravo5Ranferi Aragon-Nogales6Maribel Ibarra-Sarlat7Juan Carlos Núñez-Enríquez8Pediatric Intensive UnitDepartment of Medical GeneticsPediatric Intensive UnitPediatric Intensive UnitFaculty of MedicinePediatric CardiologyFaculty of MedicinePediatric Intensive UnitClinical Epidemiology Medical Research UnitIntroduction. Down syndrome (DS) is one of the most frequent genomic disorders around the globe (∼1:700 births). During the COVID-19 pandemic, it has been recognized that children with DS are patients with a greater risk of presenting SARS-CoV-2 infection-related poor outcomes. Nonetheless, a few cases with DS and SARS-CoV-2 infection have been reported. Our aim is to describe the unfavorable clinical course of a child with DS infected with SARS-CoV-2 virus. Case. Female, 2 years old, karyotype 47,XX,+21[30], previously diagnosed with a cyanotic congenital heart disease (tricuspid atresia and infundibular pulmonary stenosis, type Ib) who started with diarrhea, developed shortness of breath, and cyanosis and was admitted to the hospital presenting low-oxygen saturation (33%) requiring invasive mechanical ventilation support. The patient tested positive for SARS-CoV-2 infection. During hospitalization, the patient presented hypotension, anuria, retarded capillary filling, and metabolic acidosis; management with vasoactive drugs was needed. Nonetheless, the patient developed respiratory and cardiac failure, acute renal injury (AKIN-III), and septic shock. After 24 days of hospitalization, the patient died. Conclusions. Multiple organ failure observed in the patient presented could be related to the triple gene dose of four interferon receptors (IFNAR1, IFNAR2, IFNGR2, and IL10RB) located at 21q22.11. Additionally, overexpression of TMPRSS2 at the pulmonary level, located also at 21q22.3, could be related with an increased susceptibility for the development of SARS-CoV-2 infection in DS patients.http://dx.doi.org/10.1155/2021/5893242 |
| spellingShingle | Perla Idalia Vazquez-Hernández Alan Cárdenas-Conejo Manuel Alejandro Catalán-Ruiz Karla Navar-Gallegos Emilio Zenteno-Salazar Jose Rafael-Parra-Bravo Ranferi Aragon-Nogales Maribel Ibarra-Sarlat Juan Carlos Núñez-Enríquez Multiple Organ Failure Associated with SARS-CoV-2 Infection in a Child with Down Syndrome: Is Trisomy 21 Associated with an Unfavourable Clinical Course? Case Reports in Pediatrics |
| title | Multiple Organ Failure Associated with SARS-CoV-2 Infection in a Child with Down Syndrome: Is Trisomy 21 Associated with an Unfavourable Clinical Course? |
| title_full | Multiple Organ Failure Associated with SARS-CoV-2 Infection in a Child with Down Syndrome: Is Trisomy 21 Associated with an Unfavourable Clinical Course? |
| title_fullStr | Multiple Organ Failure Associated with SARS-CoV-2 Infection in a Child with Down Syndrome: Is Trisomy 21 Associated with an Unfavourable Clinical Course? |
| title_full_unstemmed | Multiple Organ Failure Associated with SARS-CoV-2 Infection in a Child with Down Syndrome: Is Trisomy 21 Associated with an Unfavourable Clinical Course? |
| title_short | Multiple Organ Failure Associated with SARS-CoV-2 Infection in a Child with Down Syndrome: Is Trisomy 21 Associated with an Unfavourable Clinical Course? |
| title_sort | multiple organ failure associated with sars cov 2 infection in a child with down syndrome is trisomy 21 associated with an unfavourable clinical course |
| url | http://dx.doi.org/10.1155/2021/5893242 |
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