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For people with Down syndrome, family members, caregivers and professionals.

Recommendations for Treatment of Mild to Moderate COVID-19 Infection

April 2022 | Brian Chicoine, MD, Erin Dominiak, MD, and Hannah Graham, MD - Adult Down Syndrome Center

We have only seen or heard of a few cases of severe COVID-19 infection in our patients with Down syndrome who have received COVID-19 vaccines. Our experience has been consistent with the data from the Trisomy 21 Research Society survey study that demonstrated the safety and effectiveness of COVID-19 vaccines in individuals with Down syndrome.

However, prior to the availability of the vaccine, an earlier publication from the Trisomy 21 Research Society survey study demonstrated people with Down syndrome were particularly at risk for severe complications from COVID-19 infection, especially those older than 40 years of age and those with other health conditions.

At this time, we have limited data on when the immunity from the vaccine (or a prior infection) may wane. In addition, we consider people with Down syndrome as potentially high risk for progressing to severe COVID-19 based on the pre-vaccine Trisomy 21 Research Society study referenced above. Therefore, we are following National Institutes of Health (NIH) COVID-19 treatment guidelines The preceding link opens in a new tab or window.. These guidelines are for people who previously had COVID-19 vaccines and/or the illness and for those who have had neither the illness nor the vaccine.

The NIH’s first preferred treatment is nirmatrelvir-ritonavir (Paxlovid) for individuals who develop mild to moderate COVID-19 infections, are at risk to develop severe disease, who are not in the hospital, and who do not have a contraindication. It is a series of pills (tablets). The second option is remdesivir.  When given to people with mild to moderate disease who are not in the hospital, it is given intravenously (IV) every 24 hours for 3 doses. Paxlovid must be started within 5 days of the onset of symptoms and remdesivir within 7 days. There are some additional treatment options if those first two are not appropriate or available.

The World Health Organization The preceding link opens in a new tab or window. is also recommending these treatments.


Additional resources can be found in the COVID-19 section of our Resource Library. 

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Please note: The information on this site is for educational purposes only and is not intended to serve as a substitute for a medical, psychiatric, mental health, or behavioral evaluation, diagnosis, or treatment plan by a qualified professional. We recommend you review the educational material with your health providers regarding the specifics of your health care needs.