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Abdeltawab MSA, Fateen M, Saad El-Din S, Elmessiery RM, Mohammady Mohamed O, Marzouk Sadek K, Medhat E, Hamed AMR. Effect of SARS-CoV-2 and Toxoplasma gondii co-infection on IFN-γ and TNF-α expression and its impact on disease severity. Cytokine 2024; 177:156545. [PMID: 38368695 DOI: 10.1016/j.cyto.2024.156545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 02/07/2024] [Accepted: 02/09/2024] [Indexed: 02/20/2024]
Abstract
The symptomatology of COVID-19 is dependent on the immune status and the cytokine response of the host. The cytokine level of the host is influenced by the presence of chronic persistent or latent infections with co-pathogens. Parasitic diseases are known to induce host immune-modulation which may impact the response to co-infection. Toxoplasmosis is a widespread protozoal infection that remains quiescent in its latent form to be re-activated during states of immune depression. Clinical data on the relation between toxoplasmosis and COVID-19 cytokine profile and symptomatology are still insufficient. Seventy-nine subjects were included in this study. Patients were diagnosed with COVID-19 by PCR. Serological testing for toxoplasmosis was performed by the detection of anti-Toxoplasma IgG antibodies, in addition to IgG avidity testing. IFN-γ and TNF-α levels were determined by RT-PCR. Among patients diagnosed with COVID-19, 67.1% were seronegative for anti-Toxoplasma IgG, while 32.9% were seropositive. High avidity was found in 10 cases (40% of seropositive cases), 4 of whom required ICU administration, while low avidity was found in 15 cases (60%), 7 of which were administered to the ICU. TNF-α and INF-γ levels were significantly higher in COVID-19 patients than in healthy control subjects. No significant association was found between the seroprevalence of toxoplasmosis and the presence of COVID-19 and its severity. Cytokines were significantly higher in both seropositive and seronegative COVID-19 patients than in their control counterparts. The high prevalence of toxoplasmosis merits further exploration of its relation to COVID-19 by mass studies.
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Affiliation(s)
| | - Mohamed Fateen
- Clinical and Chemical Pathology Department, Faculty of Medicine, Cairo University, Egypt
| | - Shimaa Saad El-Din
- Medical Biochemistry and Molecular Biology Department, Faculty of Medicine, Cairo University, Egypt
| | - Riem M Elmessiery
- Internal Medicine Department, Faculty of Medicine, Cairo University, Egypt
| | | | | | - Engy Medhat
- Medical Biochemistry and Molecular Biology Department, Faculty of Medicine, Cairo University, Egypt
| | - Alshaimaa M R Hamed
- Medical Parasitology Department, Faculty of Medicine, Cairo University, Egypt
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Hamdy DA, Eid RA, Abdel-Tawab H, El-Badry MA, Abdallah AM, El Wahab WMA. Impact of latent toxoplasmosis on pneumonic and non-pneumonic COVID-19 patients with estimation of relevant oxidative stress biomarkers. Folia Parasitol (Praha) 2024; 71:2024.008. [PMID: 38628099 DOI: 10.14411/fp.2024.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 02/16/2024] [Indexed: 04/19/2024]
Abstract
Susceptibility to COVID-19, the most devastating global pandemic, appears to vary widely across different population groups. Exposure to toxoplasmosis has been proposed as a theory to explain the diversity of these populations. The aim of the present study was to investigate the possible association between latent toxoplasmosis and COVID-19 and its probable correlation with markers of oxidative stress, C-reactive protein (CRP) and ferritin. In a case-control study, blood samples were collected from 91 confirmed (48 non-pneumonic; NP, and 43 pneumonic; P) COVID-19 patients and 45 healthy controls. All participants were tested for IgG anti-Toxoplasma gondii antibodies and oxidative stress markers (nitric oxide [NO], superoxide dismutase [SOD] and reduced glutathione [GSH]), and CRP and serum ferritin levels were determined. In COVID-19 patients, IgG anti-T. gondii antibodies were found in 54% compared to 7% in the control group, with the difference being statistically significant (P ˂ 0.001). However, no significant correlation was found between the severity of COVID-19 and latent T. gondii infection. Latent toxoplasmosis had a strong influence on the risk of COVID-19. NO and SOD levels were significantly increased in COVID-19 patients, while GSH levels decreased significantly in them compared to control subjects (P ˂ 0.001 for both values). CRP and ferritin levels were also significantly elevated in P COVID-19 patients infected with toxoplasmosis. This is the first study to look at the importance of oxidative stress indicators in co-infection between COVID-19 and T. gondii. The high prevalence of latent toxoplasmosis in COVID-19 suggests that T. gondii infection can be considered a strong indicator of the high risk of COVID-19.
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Affiliation(s)
- Doaa A Hamdy
- Department of Medical Parasitology, College of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Ragaey A Eid
- Department of Gastroenterology, Hepatology and infectious diseases (Tropical Medicine Department), College of Medicine, Beni-Suef University, Beni-Suef,Egypt
| | - Heba Abdel-Tawab
- Department of Zoology, Faculty of Science, Beni-Suef University, Beni-Suef, Egypt
| | - Mohamed A El-Badry
- Research Institute of Medical Entomology, General Organisation for Teaching Hospitals and Institutes (GOTHI), Giza, Egypt
| | - Abdelrahman M Abdallah
- Department of Chest Diseases, College of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Wegdan M Abd El Wahab
- Department of Medical Parasitology, College of Medicine, Beni-Suef University, Beni-Suef, Egypt
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Montalbano G, Kung VM, Franco-Paredes C, Vargas Barahona L, Chastain DB, Tuells J, Henao-Martínez AF, Montoya JG, Reno E. Positive Toxoplasma IgG Serology Is Associated with Increased Overall Mortality - A Propensity Score-Matched Analysis. Am J Trop Med Hyg 2024; 110:238-245. [PMID: 38109768 PMCID: PMC10859811 DOI: 10.4269/ajtmh.23-0537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 10/06/2023] [Indexed: 12/20/2023] Open
Abstract
Toxoplasma gondii is a prevalent parasitic disease with significant morbidity and mortality in immunocompromised populations. We lack long-term outcomes for latent infections. We aimed to elucidate the relationship between latent T. gondii infection and mortality risk. We queried TriNetX, a international multicenter network, to validate mortality risk differences among patients with positive or negative toxoplasma IgG through propensity score matching (PSM). We excluded patients with toxoplasmosis disease by International Classification of Diseases codes or polymerase chain reaction testing. We found 28,138 patients with available toxoplasma IgG serology. Seropositive patients were older and had a male preponderance. More seropositive patients identified as Hispanic, Latino, or Black persons. Patients who were positive for T. gondii IgG serology were slightly more likely to have underlying heart failure, a transplanted organ or tissue, malignant neoplasms of lymphoid or hematopoietic tissues, and diseases of the nervous system than seronegative controls. After PSM of patients with positive (N = 6,475) and negative (N = 6,475) toxoplasma IgG serologies, toxoplasmosis-positive patients were more likely to have long-term drug use but less likely to suffer from behavioral disorders. The overall PSM 1- and 5-year mortality was higher among patients with a positive toxoplasma IgG serology. The risk of schizophrenia was increased at 5 years. We found a prevalence of toxoplasma IgG positivity of 0.03% during the last 3 years. Latent T. gondii associates with a higher overall mortality risk. The study of social determinants of health and follow-up studies are necessary to corroborate the findings and find possible causal mechanisms.
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Affiliation(s)
- Gabrielle Montalbano
- Division of Infectious Diseases, Department of Medicine, School of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, Colorado
| | - Vanessa M. Kung
- Division of Infectious Diseases, Department of Medicine, School of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, Colorado
| | - Carlos Franco-Paredes
- Hospital Infantil de México, Federico Gómez, Mexico City, Mexico
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, Colorado
| | - Lilian Vargas Barahona
- Division of Infectious Diseases, Department of Medicine, School of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, Colorado
| | - Daniel B. Chastain
- Department of Clinical and Administrative Pharmacy, University of Georgia College of Pharmacy, Albany, Georgia
| | - Jose Tuells
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, Spain
| | - Andrés F. Henao-Martínez
- Division of Infectious Diseases, Department of Medicine, School of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, Colorado
| | - José G. Montoya
- Jack S. Remington Laboratory for Specialty Diagnostics, National Reference Center for the Study and Diagnosis of Toxoplasmosis, Palo Alto, California
| | - Elaine Reno
- Department of Emergency Medicine, School of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, Colorado
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Hasanzadeh M, Ahmadpour E, Mahami-Oskouei M, Musavi S, Parsaei M, Sarafraz N, Spotin A. Genetic diversity and seroprevalence of Toxoplasma gondii in COVID‑19 patients; a first case-control study in Iran. BMC Infect Dis 2024; 24:42. [PMID: 38172676 PMCID: PMC10763165 DOI: 10.1186/s12879-023-08964-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 12/28/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Toxoplasmosis is a serious or life-threatening disease in immunosuppressed patients and pregnant women. This study examined the likely association between Toxoplasma gondii infection and COVID-19 patients with moderate illness. METHODS Seventy blood samples were collected from patients at the Health Reference Laboratory of Tabriz, Northwest Iran from April 2021 to September 2021. In addition, 70 healthy subjects of the same age (37 ± 15 years) and sex distribution were ethnically matched. Sera samples were examined for the detection of anti-Toxoplasma antibodies using ELISA. Nested-PCR targets were amplified based on the B1 and GRA6 genes. GRA6 amplicons were subjected to sequencing and phylogenetic analysis. RESULTS The seroprevalence of toxoplasmosis based on IgG titer was 35.7% in the COVID‑19 patients and 27.1% in the control group, representing not to be associated with the Toxoplasma seropositivity in COVID‑19 patients (P = 0.18) compared to healthy subjects. Anti-T. gondii IgM was not found in any of the patients and healthy individuals. According to PCR amplification of the B1 and GRA6 genes, the frequency of T. gondii in COVID-19 patients was 14.2% (10/70). However, no T. gondii infection was detected in the healthy group. The CD4+T cell count was relatively lower in toxoplasmosis-infected patients (430-450 cells/mm3) than in control group (500-1500 cells/mm3). High genetic diversity (Hd: 0.710) of the type I strain of T. gondii was characterized in the patients. Present results showed that consumption of raw vegetables and close contact with stray cats can increase the transmission of T. gondii to COVID-19 patients (P < 0.01). CONCLUSIONS The current study revealed that T. gondii type I infection is unequivocally circulating among the COVID-19 patients in Tabriz; However, no significant association was observed between the occurrence of Toxoplasma and the severity of COVID-19. To make more accurate health decisions, multicenter investigations with a larger sample size of different ethnic groups of the Iranian population are needed.
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Affiliation(s)
- Mehdi Hasanzadeh
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Parasitology and Mycology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ehsan Ahmadpour
- Infectious and Tropical Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahmoud Mahami-Oskouei
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Parasitology and Mycology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saeed Musavi
- Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of medical science, Tabriz, Iran
| | - Mahdi Parsaei
- Vice chancellor for health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nazila Sarafraz
- Vice chancellor for health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Adel Spotin
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
- Department of Parasitology and Mycology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
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Flegr J, Latifi A. COVID's long shadow: How SARS-CoV-2 infection, COVID-19 severity, and vaccination status affect long-term cognitive performance and health. Biol Methods Protoc 2023; 8:bpad038. [PMID: 38130975 PMCID: PMC10733723 DOI: 10.1093/biomethods/bpad038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 11/30/2023] [Accepted: 12/05/2023] [Indexed: 12/23/2023] Open
Abstract
COVID-19 affects a variety of organs and systems of the body including the central nervous system. Recent research has shown that COVID-19 survivors often experience neurological and psychiatric complications that can last for months after infection. We conducted a large Internet study using online tests to analyze the effects of SARS-CoV-2 infection, COVID-19 severity, and vaccination on health, intelligence, memory, and information processing precision and speed in a cohort of 4445 subjects. We found that both SARS-CoV-2 infection and COVID-19 severity were associated with negative impacts on patients' health. Furthermore, we observed a negative association between COVID-19 severity and cognitive performance. Younger participants had a higher likelihood of SARS-CoV-2 contraction, while the elderly had a higher likelihood of severe COVID-19 and vaccination. The association between age and COVID-19 severity was primarily mediated by older participants' impaired long-term health. Vaccination was positively associated with intelligence and the precision of information processing. However, the positive association between vaccination and intelligence was likely mediated by achieved education, which was itself strongly associated with the likelihood of being vaccinated.
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Affiliation(s)
- Jaroslav Flegr
- Department of Philosophy and History of Sciences, Faculty of Science, Laboratory of Evolutionary Biology, Charles University, Prague 128 00, Czechia
| | - Ashkan Latifi
- Department of Philosophy and History of Sciences, Faculty of Science, Laboratory of Evolutionary Biology, Charles University, Prague 128 00, Czechia
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Latifi A, Flegr J. Is recovery just the beginning? Persistent symptoms and health and performance deterioration in post-COVID-19, non-hospitalized university students-a cross-sectional study. Biol Methods Protoc 2023; 8:bpad037. [PMID: 38144461 PMCID: PMC10739555 DOI: 10.1093/biomethods/bpad037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 11/18/2023] [Accepted: 12/04/2023] [Indexed: 12/26/2023] Open
Abstract
Many individuals experience persistent symptoms such as deteriorated physical and mental health, increased fatigue, and reduced cognitive performance months after recovering from coronavirus disease 2019 (COVID-19). There is limited data on the long-term trajectory and prevalence of these symptoms, especially in milder cases. Our study aimed to assess the persistent effects of COVID-19 on physical and mental health, fatigue, and cognitive performance in a cohort of 214 students, averaging 21.8 years of age. Of these, 148 had contracted COVID-19 but were not hospitalized, with the time since infection ranging from 1 to 39 months. We utilized a comprehensive panel of cognitive tests to measure intelligence, memory, and psychomotor skills, and a detailed anamnestic questionnaire to evaluate physical and mental health. While contracting COVID-19 did not significantly impact overall health and performance, it was associated with increased reports of fatigue. However, the reported severity of the disease had a pronounced negative influence on physical health, mental well-being, fatigue, and reaction time. Trends of improvement in physical and mental health, as well as error rate, were observed within the first 2 years post-infection. However, fatigue and reaction time showed a trend of deterioration. Beyond the 2-year mark, physical health and error rate continued to improve, while mental health began to deteriorate. Fatigue and reaction time continued to decline. Overall, our findings suggest that some effects of contracting COVID-19 can persist or even deteriorate over time, even in younger individuals who had mild cases that did not require hospitalization.
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Affiliation(s)
- Ashkan Latifi
- Department of Philosophy and History of Sciences, Faculty of Science, Laboratory of Evolutionary Biology, Charles University, Viničná 7, Prague 128 00, Czechia
| | - Jaroslav Flegr
- Department of Philosophy and History of Sciences, Faculty of Science, Laboratory of Evolutionary Biology, Charles University, Viničná 7, Prague 128 00, Czechia
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Mahmoudi MR, Saadat F, Yaghubi Kalurazi T, Ali Verdiloo F, Karanis P. Latent toxoplasmosis in COVID-19 patients and link with higher mortality in COVID-19 male patients. Microb Pathog 2023; 185:106402. [PMID: 37866548 DOI: 10.1016/j.micpath.2023.106402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 10/16/2023] [Accepted: 10/17/2023] [Indexed: 10/24/2023]
Abstract
BACKGROUND Immunocompromised patients may be at risk for reactivating the toxoplasmosis infection; therefore, early diagnosis would be highly desirable in these individuals. This study evaluated the possible association between coronavirus disease 2019 (COVID-19) and latent Toxoplasma gondii infection in Guilan province, Iran. MATERIALS AND METHODS The study was performed among 210 COVID-19 patients referred to Guilan University of Medical Sciences hospitals in 2022. Peripheral blood samples were taken for serum separation, collected into tubes, and kept at - 20 °C until use. Blood samples were obtained from COVID-19 patients. IgG antibody to Toxoplasma gondii was detected by a commercial ELISA kit. Accordingly, IgG absorbance levels <9 were considered harmful, 9-11 was considered borderline, and >11 was positive. RESULTS Toxoplasma IgG antibodies were found in 73.9 % of patients with COVID-19 in male patients. The seroprevalence of Toxoplasma in dead and lived COVID-19 male patients was 83.3 % and 66.7 %, respectively, and this difference was significant. A present study found a significant correlation between the rising titer of Toxoplasma IgG and the severity of COVID-19. There was no significant difference between the hospitalization duration factor and the seropositivity rate. CONCLUSION Regarding the significant association between the rising titer of Toxoplasma IgG and the severity of COVID-19. The findings demonstrated an association between the severity and mortality rate of COVID-19 with higher titer Anti-Toxoplasma IgG antibodies. Toxoplasmosis is currently considered a risk factor for COVID-19.
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Affiliation(s)
- Mohammad Reza Mahmoudi
- Department of Parasitology and Mycology, School of Medicine, Guilan University of Medical Sciences, Iran
| | - Farshid Saadat
- Department of Immunology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Tofigh Yaghubi Kalurazi
- Department of Health, Nutrition and Infectious Diseases, School of Medicine Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Faizeh Ali Verdiloo
- Department of Parasitology and Mycology, School of Medicine, Guilan University of Medical Sciences, Iran
| | - Panagiotis Karanis
- University of Cologne, Medical Faculty and University Hospital, Cologne, Germany; Department of Basic and Clinical Sciences, University of Nicosia Medical School, Nicosia, Cyprus.
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Flegr J, Ullmann J, Toman J. Parasitic manipulation or side effects? The effects of past Toxoplasma gondii and Borrelia spp. infections on human personality and cognitive performance are not mediated by impaired health. Folia Parasitol (Praha) 2023; 70:2023.020. [PMID: 38084079 DOI: 10.14411/fp.2023.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 10/31/2023] [Indexed: 12/18/2023]
Abstract
Bacteria Borrelia burgdorferi s. l. and even more the protist Toxoplasma gondii Nicolle et Manceaux, 1908, are known to affect the behaviour and mental health of their animal and human hosts. Both pathogens infect a significant fraction of human population, both are neurotropic and survive in the host's body for a long time. While latent infections were thought to be clinically asymptomatic, recent studies suggest otherwise, revealing adverse effects on human health. It was hypothesised that the specific behavioural effects of these pathogens may be side effects of general health impairments in infected individuals. This hypothesis was tested using about one hour-long survey consisting of questionnaires and performance tests on a cohort of 7,762 members of the internet population. Results showed that individuals infected with T. gondii reported worse physical and mental health, and those infected with Borrelia spp. reported worse physical health than uninfected controls. Furthermore, infected and noninfected individuals differed in several personality traits, including conscientiousness, pathogen disgust, injury disgust, Machiavellianism, narcissism, tribalism, anti-authoritarianism, intelligence, reaction time, and precision. While the majority of behavioural effects associated with Borrelia infection were similar to those associated with Toxoplasma infection, some differences were observed, such as performance in the Stroop test. Path analyses and nonparametric partial Kendall correlation tests showed that these effects were not mediated by impaired health in infected individuals, contradicting the side effects hypothesis.
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Gouda MA, AboShabaan HS, Abdelgawad AS, Abdel Wahed AS, A Abd El-Razik K, Elsaadawy Y, Abdel-Wahab AA, Hawash Y. Association between breakthrough infection with COVID-19 and Toxoplasma gondii: a cross-sectional study. Sci Rep 2023; 13:17636. [PMID: 37848511 PMCID: PMC10582182 DOI: 10.1038/s41598-023-44616-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 10/10/2023] [Indexed: 10/19/2023] Open
Abstract
The breakthrough infection following COVID-19 vaccination has been a subject of concern recently. Evidence suggests that COVID-19 vaccine efficacy diminishes over time due to multiple factors related to the host, and vaccine. Coinfection with other pathogens was claimed earlier as a contributing cause for this phenomenon. Hence, we aimed to stratify the association of post-COVID-19 vaccination breakthrough coinfection with Toxoplasma gondii (T. gondii) and its impact on disease severity. This cross-sectional study included 330 COVID-19-vaccinated patients confirmed by RT-PCR. They were also screened for anti- T. gondii antibodies using ELISA. Toxoplasma seropositive cases' whole blood was screened for DNA using PCR to correlate results with COVID-19 severity. Out of 330 COVID-19 vaccinated patients with breakthrough infection, 34.5% (114 patients) showed positivity for Toxoplasma IgG by ELISA, and none of the cases was IgM positive. Eleven patients (9.6%) of the IgG-positive cases were positive by PCR. Positive PCR cases correlated positively with the Toxoplasma IgG titer (P < 0.001), and the Cutoff point was 191.5. Molecular analysis of Toxoplasma and COVID-19 severity showed that 8 (72.7%), 1 (9.1%), and 2 cases (18.2%) had mild, moderate, and severe courses of the disease, respectively, with no significant correlation. Our study reported a heightened prevalence of latent toxoplasmosis among mild cases of COVID-19 breakthrough infection. Nevertheless, a discernible correlation between latent toxoplasmosis and COVID-19 severity is lacking. Hence, implementing studies on a larger scale could provide a more comprehensive comprehension of this association.
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Affiliation(s)
- Marwa A Gouda
- Department of Clinical and Molecular Parasitology, National Liver Institute, Menoufia University, Shibin El Kom, Menoufia, Egypt.
| | - Hind S AboShabaan
- Department of Clinical Pathology, National Liver Institute, Menoufia University, Shibin El Kom, Menoufia, Egypt
| | - Ahmed S Abdelgawad
- Department of Clinical Pathology, National Liver Institute, Menoufia University, Shibin El Kom, Menoufia, Egypt
| | - Aliaa Sabry Abdel Wahed
- Department of Hepatology and Gastroenterology, National Liver Institute, Menoufia University, Shibin El Kom, Menoufia, Egypt
| | - Khaled A Abd El-Razik
- Department of Animal Reproduction, National Research Centre (NRC), Dokki, Giza, Egypt
| | - Yara Elsaadawy
- Department of Medical Microbiology, Immunology, and Infection Control, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ayman A Abdel-Wahab
- Department of Clinical and Molecular Parasitology, National Liver Institute, Menoufia University, Shibin El Kom, Menoufia, Egypt
| | - Yousry Hawash
- Department of Clinical and Molecular Parasitology, National Liver Institute, Menoufia University, Shibin El Kom, Menoufia, Egypt
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Habib S, Hamza E, El-Gamal R, Nosser NA, Aboukamar WA, Abdelsalam S, Sobh A, Elegezy M, Elbayoumy M, Eldars W, Elmasry K, Elnagdy MH. Clinical and Immunological Impacts of Latent Toxoplasmosis on COVID-19 Patients. Cureus 2023; 15:e45989. [PMID: 37900421 PMCID: PMC10601516 DOI: 10.7759/cureus.45989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2023] [Indexed: 10/31/2023] Open
Abstract
Background Parasites are well-known immune-modulators. They inhibit some aspects of the immune system to ensure persistence inside the host for a long time; meanwhile, they stimulate other immune aspects to assure the survival of the host. Wide variations in the severity of coronavirus disease 2019 (COVID-19) among developed and developing countries were reported during the COVID-19 pandemic. Parasitic infections, including Toxoplasma gondii (T. gondii), were claimed to contribute to such variations. Methods To explore a possible relationship between latent toxoplasmosis and COVID-19 severity, our study included 44 blood samples from moderate/severe COVID-19 patients, who were admitted to Mansoura University Hospitals, Egypt, during the pandemic. Patients' sera were screened for Toxoplasma IgG antibodies using ELISA (Roche Diagnostics, Indianapolis, USA), and the gene expression of important immune markers (iNOS, arginase-1, IFN-γ, TNF-α, IL-6, IL-10, and TGF-β) was checked using real-time quantitative PCR. Clinical and laboratory data were obtained from the patients' medical records. Results Toxoplasma IgG antibodies were detected in 33 (75%) of patients. None of the studied clinical or laboratory parameters showed any significant changes in relation to toxoplasmosis seroprevalence. Further classification of the patients according to COVID-19 severity and Toxoplasma seroprevalence did not reveal any changes related to toxoplasmosis as well. Conclusion Our study indicates that latent toxoplasmosis has no effect on the severity of COVID-19.
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Affiliation(s)
- Samar Habib
- Department of Medical Parasitology, Faculty of Medicine, Mansoura University, Mansoura, EGY
| | - Eman Hamza
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Mansoura University, Mansoura, EGY
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Horus University, New Damietta, EGY
| | - Randa El-Gamal
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Mansoura University, Mansoura, EGY
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Horus University, New Damietta, EGY
- Medical Experimental Research Center (MERC), Faculty of Medicine, Mansoura University, Mansoura, EGY
| | - Nessma A Nosser
- Department of Clinical Pathology, Faculty of Medicine, Mansoura University, Mansoura, EGY
| | - Wafaa A Aboukamar
- Department of Medical Parasitology, Faculty of Medicine, Mansoura University, Mansoura, EGY
| | - Sherehan Abdelsalam
- Department of Community Medicine, Faculty of Medicine, Mansoura University, Mansoura, EGY
| | - Ali Sobh
- Department of Pediatrics, Mansoura University Children's Hospital, Faculty of Medicine, Mansoura University, Mansoura, EGY
| | - Mohamed Elegezy
- Department of Tropical Medicine, Faculty of Medicine, Mansoura University, Mansoura, EGY
| | - Mohamed Elbayoumy
- Department of Gastroenterology and Hepatology, King Saud Medical City, Riyadh, SAU
| | - Waleed Eldars
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Mansoura University, Mansoura, EGY
- Department of Basic Medical Sciences, Faculty of Medicine, New Mansoura University, New Mansoura, EGY
| | - Khaled Elmasry
- Department of Oral Biology and Diagnostic Sciences, Dental College of Georgia, Augusta University, Augusta, USA
- Department of Human Anatomy and Embryology, Faculty of Medicine, Mansoura University, Mansoura, EGY
| | - Marwa H Elnagdy
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Mansoura University, Mansoura, EGY
- Department of Basic Medical Sciences, Faculty of Medicine, New Mansoura University, New Mansoura, EGY
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Galván-Ramírez MDLL, Salas-Lais AG, Muñoz-Medina JE, Fernandes-Matano L, Pérez LRR, Franco de León K. Association of Toxoplasmosis and COVID-19 in a MexicanPopulation. Microorganisms 2023; 11:1441. [PMID: 37374943 DOI: 10.3390/microorganisms11061441] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 05/15/2023] [Accepted: 05/26/2023] [Indexed: 06/29/2023] Open
Abstract
SARS-CoV-2 is the causal agent of COVID-19; the first report of SARS-CoV-2 infection was in December 2019 in Wuhan, China. This virus has since caused the largest pandemic in history, and the number of deaths and infections has been significant. Nevertheless, the development of vaccines has helped to reduce both deaths and infections. Comorbidities such as diabetes, hypertension, heart and lung diseases, and obesity have been identified as additional risk factors for infection and the progression of COVID-19. Additionally, latent toxoplasmosis has been reported to be a risk factor for acquiring COVID-19 in some studies, but other studies have suggested a negative association between these two infections. Furthermore, in patients after vaccination or with COVID-19 and coinfection, an increase in the lethality and mortality of toxoplasmosis has been observed. Therefore, the objective of the current study is to determine the association of toxoplasmosis with COVID-19 in patients diagnosed with COVID-19. Serum samples from 384 patients previously diagnosed with COVID-19 using IgG antibodies against the S1/S2 antigens of SARS-CoV-2 were collected. Subsequently, anti-Toxoplasma IgG and IgM antibodies were analyzed with ELISA. Statistical analysis was performed using SPSS Version 20.0 frequencies, percentages, 2 × 2 tables, and the Pearson correlation coefficient. IgG and IgM anti-Toxoplasma antibodies were positive in 105/384 (27.34%) and (26/191) 13.6% of patients, respectively. The positivity for both infections was higher in patients aged >40 years old. Subjects who were overweight or obese were mainly positive for both IgG antibodies against S1/S2 SARS-CoV-2 and Toxoplasma antibodies. In conclusion, the coinfection rate was 21.7%. The prevalence of S1/S2 SARS-CoV-2 was 308/384 (80.2%), and the percentage of Toxoplasma antibodies was 27.34%.
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Affiliation(s)
- María de la Luz Galván-Ramírez
- Departamento de Microbiología y Patología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
| | - Angel Gustavo Salas-Lais
- Coordinación de Calidad de Insumos y Laboratorios Especializados, Instituto Mexicano del Seguro Social, Ciudad de Mexico 07760, Mexico
| | - José Esteban Muñoz-Medina
- Coordinación de Calidad de Insumos y Laboratorios Especializados, Instituto Mexicano del Seguro Social, Ciudad de Mexico 07760, Mexico
| | - Larissa Fernandes-Matano
- Coordinación de Calidad de Insumos y Laboratorios Especializados, Instituto Mexicano del Seguro Social, Ciudad de Mexico 07760, Mexico
| | - Laura Rocío Rodríguez Pérez
- Departamento de Microbiología y Patología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
| | - Karen Franco de León
- Departamento de Microbiología y Patología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
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Co-infection of COVID-19 and parasitic diseases: A systematic review. Parasite Epidemiol Control 2023; 21:e00299. [PMID: 37091061 PMCID: PMC10062795 DOI: 10.1016/j.parepi.2023.e00299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 02/16/2023] [Accepted: 03/28/2023] [Indexed: 04/03/2023] Open
Abstract
Co-infection of COVID-19 with other diseases increases the challenges related to its treatment management. COVID-19 co-infection with parasites is studied with low frequency. Here, we systematically reviewed the cases of parasitic disease co-infection with COVID-19. All articles on COVID-19 co-infected with parasites (protozoa, helminths, and ectoparasites), were screened through defined inclusion/exclusion criteria. Of 2190 records, 35 studies remained for data extraction. The majority of studies were about COVID-19 co-infected with malaria, followed by strongyloidiasis, amoebiasis, chagas, filariasis, giardiasis, leishmaniasis, lophomoniasis, myiasis, and toxoplasmosis. No or low manifestation differences were reported between the co-infected cases and naïve COVID-19 or naïve parasitic disease. Although there was a relatively low number of reports on parasitic diseases-COVID-19 co-infection, COVID-19 and some parasitic diseases have overlapping symptoms and also COVID-19 conditions and treatment regimens may cause some parasites re-emergence, relapse, or re-activation. Therefore, more attention should be paid to the on-time diagnosis of COVID-19 and the co-infected parasites.
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13
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Mofazzal Jahromi MA, Sefidfard M, Taghipour A, Roustazadeh A, Matin S, Mir H, Badri M, Bahrami F, Abdoli A. Latent infections, coronavirus disease 2019 and psychiatric disorders: The friend of my enemy. CLINICAL AND TRANSLATIONAL DISCOVERY 2022; 2:e141. [PMID: 36712173 PMCID: PMC9875118 DOI: 10.1002/ctd2.141] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 09/26/2022] [Indexed: 11/06/2022]
Abstract
Recent reports revealed an increased rate of hospitalization and mortality of coronavirus disease 2019 (COVID-19) among patients with psychiatric disorders. On the other hand, there is a link between latent infections, including Toxoplasma gondii, herpes simplex virus type 1 (HSV-1) and cytomegalovirus (CMV) with psychiatric disorders. We individually assessed data regarding 1) the mortality rate of COVID-19 among individuals with psychiatric disorders; 2) the association of latent infections in COVID-19 patients and 3) the association between latent infections and psychiatric disorders. We developed the hypothesis that latent infection could increase the risk of severe COVID-19 among patients with psychiatric disorders. Cumulative evidence proposed that infection with toxoplasmosis, CMV and HSV-1 could increase the risk of severe acute respiratory syndrome coronavirus 2 (SARS-Co-V2) infections among patients with psychiatric disorders probably by induction of hyperinflammatory conditions. These infections are also associated with hyperinflammation and T cell exhaustion, which has also been observed in both schizophrenia and COVID-19. This hypothesis provides new insights into the role of latent infections in increasing the mortality rates of COVID-19 among individuals with psychiatric disorders. Strategies for screening, early diagnosis and treatment of these infections could be recommended for COVID-19 patients with a background of psychiatric disorders.
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Affiliation(s)
- Mirza Ali Mofazzal Jahromi
- Zoonoses Research CenterJahrom University of Medical SciencesJahromIran,Department of ImmunologySchool of MedicineJahrom University of Medical SciencesJahromIran,Department of Advanced Medical Sciences & TechnologiesJahrom University of Medical SciencesJahromIran
| | - Mina Sefidfard
- Department of PsychiatryJahrom University of Medical SciencesJahromIran,Research Center for Noncommunicable DiseasesJahrom University of Medical SciencesJahromIran
| | - Ali Taghipour
- Zoonoses Research CenterJahrom University of Medical SciencesJahromIran,Department of Parasitology and MycologyJahrom University of Medical SciencesJahromIran
| | - Abazar Roustazadeh
- Department of Advanced Medical Sciences & TechnologiesJahrom University of Medical SciencesJahromIran,Department of Biochemistry and NutritionJahrom University of Medical SciencesJahromIran
| | | | - Hamed Mir
- Department of Advanced Medical Sciences & TechnologiesJahrom University of Medical SciencesJahromIran,Department of Biochemistry and NutritionJahrom University of Medical SciencesJahromIran
| | - Milad Badri
- Medical Microbiology Research CenterQazvin University of Medical SciencesQazvinIran
| | - Fares Bahrami
- Kurdistan University of Medical SciencesKurdistanIran
| | - Amir Abdoli
- Zoonoses Research CenterJahrom University of Medical SciencesJahromIran,Research Center for Noncommunicable DiseasesJahrom University of Medical SciencesJahromIran
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14
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Anti-Toxoplasma Effects of Dracocephalum Polychaetum Essential Oil. Interdiscip Perspect Infect Dis 2022; 2022:6091834. [PMID: 35879954 PMCID: PMC9308528 DOI: 10.1155/2022/6091834] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 06/24/2022] [Accepted: 06/28/2022] [Indexed: 12/15/2022] Open
Abstract
Background Toxoplasma gondii is a common parasitic disease with a cosmopolitan prevalence, causing severe health problems. Although chemotherapy for toxoplasmosis is readily available, most have side effects. Objectives This study assesses the Dracocephalum polychaetum essential oil against T. gondii activity. In vitro, the anti-Toxoplasma effects of D. polychaetum essential oils with different concentrations were evaluated. Methods In the present study, T. gondii RH strain tachyzoites were exposed to D. polychaetum essential oil, and their viability effect on the parasite was evaluated. The viability test of tachyzoites was performed by using the staining method trypan blue in vitro. The inhibitory effect of D. polychaetum extract on T. gondii RH strain tachyzoites in the Vero cell line was evaluated. Results D. polychaetum has valuable efficacy in vitro, outperforming pyrimethamine and sulfadiazine at 30 and 90 minutes after exposure (p < 0.05). D. polychaetum essential oil showed anti-Toxoplasma activity in the cell line (IC50: 241.7 μg/mL). After T. gondii-infected Vero cells had been incubated with different concentrations of the D. polychaetum essential oil, their viability decreased in a dose-dependent manner. Conclusions In conclusion, D. polychaetum extract as an herbal medicine might be a valuable alternative to routine chemotherapy for toxoplasmosis.
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Flegr J, Flegr P, Příplatová L. The effects of 105 biological, socioeconomic, behavioral, and environmental factors on the risk of SARS-CoV-2 infection and a severe course of COVID-19: a prospective, explorative cohort study. Biol Methods Protoc 2022; 7:bpac030. [PMCID: PMC9750789 DOI: 10.1093/biomethods/bpac030] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/23/2022] [Accepted: 10/26/2022] [Indexed: 12/16/2022] Open
Abstract
Abstract
The confirmed number of SARS-CoV-2 infections up to 18 October 2022 is 626 million worldwide, but information about factors affecting the probability of infection or a severe course of COVID-19 remains insufficient and often speculative. Only a small number of factors have been rigorously examined, mostly by retrospective or cross-sectional studies.
We ran a preregistered study on 5164 Internet users who shared information with us about their exposure to 105 risk factors and reported being COVID-19 negative before the beginning of the fourth wave of COVID-19 in the Czech Republic. After the fourth wave, in which 709 (13.7%) of participants were infected, we used a partial Kendall test controlled for sex, age, and urbanization to compare the risk of infection and a severe course of the disease in subjects who initially did and did not report exposure to particular risk factors.
After the correction for multiple tests, we identified 13 factors – including male sex, lower age, blood group B, and larger household size – that increased the risk of infection and 16 factors – including mask-wearing, borreliosis in the past, use of vitamin D supplements, or rooibos drinking – that decreased it. We also identified 23 factors that increased the risk of a severe course of COVID-19 and 12 factors that decreased the risk.
This preregistered longitudinal study is of explorative nature. Therefore, although the observed effects were strong and remained highly significant even after correction for multiple tests, it will be necessary to confirm their existence in future independent studies.
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Affiliation(s)
- Jaroslav Flegr
- Division of Biology, Faculty of Science, Charles University , Prague 128 00, Czech Republic
| | - Pavel Flegr
- Faculty of Electrical Engineering, Czech Technical University in Prague , Prague 166 27, Czech Republic
| | - Lenka Příplatová
- Division of Biology, Faculty of Science, Charles University , Prague 128 00, Czech Republic
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