Sex and Gender Bias in Covid-19 Clinical Case Reports

Negative association between ascaris lumbricoides seropositivity and Covid-19 severity: insights from a study in Benin

Introduction

The COVID-19 pandemic has had devastating effects worldwide, but the trajectory of the pandemic has been milder in Low-and-Middle-Income Countries (LMICs), including those in Africa. Co-infection with helminths, such as Ascaris lumbricoides, has been suggested as a possible factor contributing to the reduced severity observed in these regions.

Methods

The present study investigated the association between Ascaris-specific antibody levels and COVID-19 severity in 276 SARS-CoV-2-infected individuals in Benin. Participants were categorized into asymptomatic (n=100), mild (n=150), and severe (n=26) groups based on clinical disease severity. Sera were collected and analyzed using ELISA to measure Ascaris and SARS-CoV-2-specific antibodies, while Luminex was used to assess cytokines and SARS-CoV-2-specific neutralizing antibody expression.

Results and discussion

The results demonstrated that asymptomatic SARS-CoV-2 seropositive individuals expressed, on average, 1.7 and 2.2-times higher levels of Ascaris antibodies compared to individuals with mild and severe COVID-19, respectively. This finding suggests an inverse correlation between Ascaris antibody levels and COVID-19 severity. Notably, logistic regression analysis showed that Ascaris seropositivity was significantly associated with a reduced risk of severe COVID-19 (OR = 0.277, p = 0.021). Interestingly, COVID-19 patients with comorbidities such as type 2 diabetes and high blood pressure showed lower expression of Ascaris antibodies. Strikingly, no correlation was observed between Ascaris antibody levels and SARS-CoV-2-specific neutralizing antibodies. On the other hand, individuals seronegative for Ascaris displayed significantly higher levels of systemic pro-inflammatory markers compared to seropositive individuals. These findings suggest that higher expression of Ascaris antibodies is associated with asymptomatic SARS-CoV-2 infections and may contribute to the reduction of the risk to develop severe COVID-19. The beneficial effect of Ascaris seropositivity on COVID-19 outcomes in Benin may be attributed to a decrease in comorbidities and pro-inflammatory markers. These observations provide valuable insights into the milder COVID-19 trajectory observed in Africa and may have implications for future therapeutic strategies.

Bibliometric Analysis on Bibliometric Studies of Case Reports in the Medical Field

The studies on bibliometric analyses of case reports usually give valuable information regarding various aspects of case reports but lack investigation analysing these publications. This is the first-ever study to examine the bibliometric articles on case reports; hence, it is hypothesized to provide a valuable contribution to this gap. PubMed and SCOPUS databases were searched, and a total of 119 articles were obtained, but only five were analyzed matching the inclusion criteria. The keywords involved in the search were “Bibliometrics”, “analysis”, “case reports”, "case series”, and “articles” whereas, the time range in which the case reports were searched for was between 2011-2021. Common parameters from these five articles were employed for bibliometric analysis, which included publication year, publication type, the number of case reports per article, theme or subject of the article, citation, and impact factor (IF). Out of the five articles identified, four were published in 2021. One out of five was a case report, and the rest were review-type of articles. The overall citation number of these articles was less than 10, and the IF of these articles was between 0-0.007. The number of citations of the articles was in a period of one to two years or less than one year. A comprehensive overview of the parametrises, as well as the recent trends that are being used to conduct bibliometric analysis on case reports was acquired.