COVID-19 infection in a Down syndrome child

The clinical spectrum of COVID-19 infection varies from asymptomatic to critical illness. In children, it is usually asymptomatic or milder in severity. Younger infants and children with underlying medical illnesses are more prone to develop severe diseases. Fever and cough are common presentations in children. Angiotensin-converting enzyme 2 receptor and transmembrane serine protease 2 are key proteins in the cell entry process of the virus in the gastrointestinal (GI) tract. Children with Down syndrome (DS) have increase mortality rates from COVID-19 compared to the general pediatric population. We are reporting a case of a DS baby with COVID-19 infection who presented with GI manifestations leading to hypernatremic dehydration with multiorgan dysfunction syndrome.