Table 3.
Comparison of medical complications and indicators for severity of disease in COVID-19 patients with Down syndrome from high-income countries (HIC) and India
| Unadjusted comparison |
Adjusted comparison† |
||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
|
|
HIC
|
N
|
India
|
N
|
P-value*
|
|
Beta‡
|
RR§
|
95% CI
|
P-value
|
|
| Acute respiratory distress syndrome, n (%) |
80 (47.6) |
168 |
124 (67.8) |
183 |
<0.001 |
|
N/A |
1.44 |
(0.79, 2.64) |
0.0783 |
|
| Viral pneumonia associated with COVID-19, n (%) |
187 (95.4) |
196 |
33 (20.1) |
164 |
<0.001 |
|
N/A |
0.257 |
(0.13, 0.48) |
<0.001 |
|
| Mechanical ventilation, n (%) |
58 (11.7) |
494 |
161 (41.8) |
385 |
<0.001 |
|
N/A |
2.83 |
(1.68, 4.83) |
<0.001 |
|
| Hospitalization, n (%) |
300 (38.4) |
782 |
344 (72.9) |
472 |
<0.001 |
|
N/A |
2.20 |
(1.67, 2.90) |
<0.001 |
|
| ICU admission (among those who were hospitalized), n (%) |
70 (24.8) |
282 |
231 (67.2) |
344 |
<0.001 |
|
N/A |
2.35 |
(1.53, 3.68) |
<0.001 |
|
| Death, n (%) |
97 (12.9) |
754 |
48 (10.1) |
473 |
0.179 |
|
N/A |
1.52 |
(0.65, 3.42) |
0.318 |
|
| Oxygen therapy, n (%) |
180 (44.7) |
403 |
205 (94.0) |
218 |
<0.001 |
|
N/A |
2.98 |
2.07, 4.31) |
<0.001 |
|
| CPAP/BIPAP, n (%) |
13 (6.1) |
212 |
6 (3.0) |
203 |
0.189 |
|
N/A |
1.25 |
(0.46, 3.40) |
0.66 |
|
| Extracorporeal membrane oxygenation¶, n (%) |
0 (0.0) |
374 |
3 (1.5) |
205 |
0.082 |
|
N/A |
N/A |
(N/A, N/A) |
N/A |
|
| Continuous renal-replacement therapy¶, n (%) |
3 (0.8) |
376 |
37 (17.8) |
208 |
<0.001 |
|
N/A |
N/A |
(N/A, N/A) |
N/A |
|
| Severity score**, mean (SD) | 2. 21 (1.77) | 783 | 3.31 (1.65) | 477 | <0.001 | 1.2 | N/A | (0.84, 1.4) | <0.001 | ||
HIC – high-income country, N/A – not applicable, RR – risk ratio
*Fisher exact test.
†Independent variable: country of residence (India vs HIC, HIC as reference category); dependent variable: indicators of COVID-19 severity; adjusted for survey (clinician vs · family survey), gender, age, Alzheimer disease/dementia, obesity, thyroid disorder, seizures/epilepsy, obstructive sleep apnea, hypertension, diabetes, gastroesophageal reflux, congenital heart defect.
‡Beta estimate from linear regression model with the severity score as dependent variable.
§RR from Poisson regression with robust standard errors.
Questions only part of the clinician survey.
¶No adjusted comparison because of too few cases.
**See “statistical analysis” section for details on the definition of severity score, defined according to Cao et al. [10].