Psychosocial aspects in individuals with trisomy 21 during the COVID-19 pandemic

Dear Editor 4 5 The COVID-19 pandemic has presented society with a health challenge that has 6 7 had the most impact in recent times. This continues to be a true emergency 8 worldwide (1). Numerous publications have highlighted the prevention measures 9 10 and special care required for the people with Trisomy 21, given their specific 11 12 clinical characteristics, in particular their impaired immune response and potential 13 14 For Peer Review Only complications. In addition, specific education initiatives are required on infection 15 prevention and recommendations for immunization for people with learning 16 17 difficulties (2). 18 19 However, the impact of the pandemic is not only on physical health, but also on 20 21 psychological and mental well-being. Mandated isolation or social restriction to 22 23 prevent the spread of the disease has had a major impact on the general 24 25 population and this is magnified in adults with Trisomy 21 (3), older adults with 26 intellectual disabilities (4,5), children with disabilities, and the general pediatric (1- 27 28 5). 29 30 During medical check-ups, parents or representatives of schoolchildren and 31 32 adolescents with Trisomy 21 have expressed concern about the regression of 33 34 previously achieved developmental milestones, loss of sphincter control, loss of 35 36 educational progress despite remote classes, sleep disturbances, depression, 37 irritability and behavioral disorders and aggressive episodes. Some of these 38 39 required intervention or hospitalization. 40 41 42 Although the causes of the psychosocial changes are multifactorial, it is possible 43 that the additional problems are exacerbated by the significant changes in the 44 45 lifestyles of the Trisomy 21 population in their family environment resulting in lack 46 47 of recreation, decreased physical activity, lack of interaction with their peers 48 thereby affecting their development and mental well-being. In addition, it is 49 50 important to study the wider impact on the family, including economic, and the 51 52 effects of COVID-19 within the family on the individual with Trisomy 21.