Individuals with Down syndrome are at especially high risk of hospitalization and death from the coronavirus, researchers say, adding to evidence that the virus is particularly hard on those with developmental disabilities.

People with the chromosomal disorder are four times more likely than others to be hospitalized due to COVID-19 and they face a 10 times greater risk of dying from the virus.

The findings, published in a research letter this month in the journal Annals of Internal Medicine, are based on a review of medical records for 8.26 million adults in England between late January — when the virus first emerged in that country — and June.

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The group included 4,053 people with Down syndrome and 68 died during the study period, nearly 40% of them from COVID-19. By comparison, only 20% of the 41,000-plus deaths in people without Down syndrome were related to coronavirus.

Researchers from the University of Oxford, the University of Nottingham, the London School of Hygiene & Tropical Medicine and University College London said that the higher risk did not seem to be influenced by age, sex, body mass index, smoking status or alcohol intake.

The increased risk was estimated after researchers said they adjusted for “cardiovascular and pulmonary diseases and care home residence, which our results suggest explained some but not all of the increased risk.”

Those with intellectual disabilities other than Down syndrome appeared to have a much lower risk, according to the findings.

Down syndrome is “associated with immune dysfunction, congenital heart disease, and pulmonary pathology and, given its prevalence, may be a relevant albeit unconfirmed risk factor for severe COVID-19,” the researchers wrote.

Information about the heightened risk for people with Down syndrome from COVID-19 should be used by “public health organizations, policymakers, and health care workers to strategically protect vulnerable individuals,” they indicated.

Currently, information from the Centers for Disease Control and Prevention about who is at increased risk from COVID-19 does not specifically mention Down syndrome.

“Most people with developmental or behavioral disorders are not naturally at higher risk for becoming infected with or having severe illness from novel coronavirus (COVID-19),” the CDC says. “However, people with developmental or behavioral disorders who have serious underlying medical conditions may be at risk of serious illness.”

Nonetheless, this is not the first research to suggest that COVID-19 could be more of a danger to this population. A study out earlier this year indicated that people with developmental disabilities are significantly more likely than others to die if they contract COVID-19.

Another report out just this week looking at data from California, Colorado, Indiana, Maryland, New Jersey, New York, Pennsylvania and Virginia found that people with intellectual and developmental disabilities were no more likely than others to contract the coronavirus. But, 12.3% of those with the disabilities who got COVID-19 died compared to 6.7% of virus patients in the general population.