Patients With Berardinelli-Seip and Silver-Russell Syndromes Hospitalized due to Coronavirus Disease (COVID)-19 in Brazil: A Four-Year Case Report Profile.

Berardinelli-Seip syndrome is a rare genetic disorder characterized by the near absence of subcutaneous fat and a high prevalence of metabolic complications, such as diabetes mellitus and cardiovascular disease, which may worsen coronavirus disease (COVID)-19 outcomes. Silver-Russell syndrome, also a rare genetic condition, involves intrauterine growth restriction and multiple metabolic and physical abnormalities that could potentially worsen prognosis after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This study analyzed five hospitalized patients in Brazil, two with Berardinelli-Seip syndrome and three with Silver-Russell syndrome, with confirmed COVID-19. The results showed that most patients presented respiratory symptoms and peripheral oxygen saturation below 95% at admission. Among the cases, two required intensive care and two required noninvasive ventilatory support. Four patients were discharged, while one 19-year-old patient with Berardinelli-Seip syndrome, who had multiple comorbidities and was unvaccinated, died. Symptom onset preceded hospitalization by 2-8 days in Berardinelli-Seip and 2-7 days in Silver-Russell patients. Time from symptom onset to outcome ranged from 6 to 10 days. Hospital stays were short (2-6 days). No Berardinelli-Seip patient required intensive care unit admission; two Silver-Russell patients required brief intensive care unit stays. Overall progression remained under 2 weeks. The study did not identify a consistent association between COVID-19 severity and the presence of these two syndromes, although regular multidisciplinary follow-up may have contributed to favorable outcomes in patients with Silver-Russell syndrome. Despite diagnostic and data-source limitations, the findings suggest that these rare conditions were not uniformly associated with poor outcomes, contrary to initial expectations. Further studies with larger cohorts are needed to clarify the interaction between rare diseases and COVID-19, improve risk stratification, and support clinical management in future public health emergencies.