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This retrospective cohort study compared COVID-19 cases in persons with DS hospitalized in Spain reported to the Trisomy 21 Research Society COVID-19 survey (n = 86) with admissions for non-COVID-19 pneumonias from a retrospective clinical database of the Spanish Ministry of Health (n = 2832 patients). In-hospital mortality rates were significantly higher for COVID-19 patients (26.7% vs. 9.4%), especially among individuals over 40 and patients with obesity, dementia, and\/or epilepsy. The mean length of stay of deceased patients with COVID-19 was significantly shorter than in those with non-COVID-19 pneumonias. The rate of admission to an ICU in patients with DS and COVID-19 (4.3%) was significantly lower than that reported for the general population with COVID-19. Our findings confirm that acute SARS-CoV-2 infection leads to higher mortality than non-COVID-19 pneumonias in individuals with DS, especially among adults over 40 and those with specific comorbidities. However, differences in access to respiratory support might also account for some of the heightened mortality of individuals with DS with COVID-19.<\/jats:p>","DOI":"10.3390\/jcm10163748","type":"journal-article","created":{"date-parts":[[2021,8,23]],"date-time":"2021-08-23T10:24:17Z","timestamp":1629714257000},"page":"3748","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Comparison of COVID-19 and Non-COVID-19 Pneumonia in Down Syndrome"],"prefix":"10.3390","volume":"10","author":[{"given":"Diego","family":"Real de Asua","sequence":"first","affiliation":[{"name":"Adult Down Syndrome Outpatient Unit, Department of Internal Medicine, Hospital Universitario de La Princesa, 28006 Madrid, Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria La Princesa, Hospital Universitario de La Princesa, 28006 Madrid, 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Jes\u00fas","family":"Bermejo","sequence":"additional","affiliation":[{"name":"Unidad de Neuropediatr\u00eda, Instituto Hispalense de Pediatr\u00eda, 41013 Sevilla, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domingo","family":"Gonz\u00e1lez-Lamu\u00f1o","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University Hospital Marqu\u00e9s de Valdecilla-Universidad de Cantabria, 39008 Santander, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Coral","family":"Manso","sequence":"additional","affiliation":[{"name":"Down Espa\u00f1a, 28043 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Moldenhauer","sequence":"additional","affiliation":[{"name":"Adult Down Syndrome Outpatient Unit, Department of Internal Medicine, Hospital Universitario de La Princesa, 28006 Madrid, Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria La Princesa, Hospital Universitario de La Princesa, 28006 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Carmona-Iragui","sequence":"additional","affiliation":[{"name":"Sant Pau Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Aut\u00f2noma de Barcelona, 08025 Barcelona, Spain"},{"name":"Barcelona Down Medical Center, Fundaci\u00f3 Catalana de S\u00edndrome de Down, 08029 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6005-417X","authenticated-orcid":false,"given":"Anke","family":"H\u00fcls","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie 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