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.