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Mohamed AH, Eltyeb E, Said B, Eltayeb R, Algaissi A, Hober D, Alhazmi AH. COVID-19 and malaria co-infection: a systematic review of clinical outcomes in endemic areas. PeerJ 2024; 12:e17160. [PMID: 38646476 PMCID: PMC11032658 DOI: 10.7717/peerj.17160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 03/04/2024] [Indexed: 04/23/2024] Open
Abstract
Background COVID-19 and malaria cause significant morbidity and mortality globally. Co-infection of these diseases can worsen their impact on public health. This review aims to synthesize literature on the clinical outcomes of COVID-19 and malaria co-infection to develop effective prevention and treatment strategies. Methods A comprehensive literature search was conducted using MeSH terms and keywords from the start of the COVID-19 pandemic to January 2023. The review included original articles on COVID-19 and malaria co-infection, evaluating their methodological quality and certainty of evidence. It was registered in PROSPERO (CRD42023393562). Results Out of 1,596 screened articles, 19 met the inclusion criteria. These studies involved 2,810 patients, 618 of whom had COVID-19 and malaria co-infection. Plasmodium falciparum and vivax were identified as causative organisms in six studies. Hospital admission ranged from three to 18 days. Nine studies associated co-infection with severe disease, ICU admission, assisted ventilation, and related complications. One study reported 6% ICU admission, and mortality rates of 3%, 9.4%, and 40.4% were observed in four studies. Estimated crude mortality rates were 10.71 and 5.87 per 1,000 person-days for patients with and without concurrent malaria, respectively. Common co-morbidities included Diabetes mellitus, hypertension, cardiovascular diseases, and respiratory disorders. Conclusion Most patients with COVID-19 and malaria co-infection experienced short-term hospitalization and mild to moderate disease severity. However, at presentation, co-morbidities and severe malaria were significantly associated with higher mortality or worse clinical outcomes. These findings emphasize the importance of early detection, prompt treatment, and close monitoring of patients with COVID-19 and malaria co-infection.
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Affiliation(s)
| | | | | | | | | | - Didier Hober
- Univ Lille, CHU Lille Laboratoire de Virologie ULR3610, Lille, France
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Asamoah I, Adusei-Poku M, Vandyck-Sey P, Steele-Dadzie A, Kuffour AS, Turkson A, Asante IA, Addo-Osafo K, Mohktar Q, Adu B, Afrane YA, Sagoe KWC. COVID-19 in patients presenting with malaria-like symptoms at a primary healthcare facility in Accra, Ghana. PLoS One 2024; 19:e0298088. [PMID: 38335209 PMCID: PMC10857731 DOI: 10.1371/journal.pone.0298088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 01/17/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Malaria is a common and severe public health problem in Ghana and largely responsible for febrile symptoms presented at health facilities in the country. Other infectious diseases, including COVID-19, may mimic malaria due to their shared non-specific symptoms such as fever and headache thus leading to misdiagnosis. This study therefore investigated COVID-19 among patients presenting with malaria-like symptoms at Korle-Bu Polyclinic, Accra, Ghana. METHODS This study enrolled 300 patients presenting with malaria-like symptoms aged ≥18yrs. After consent was obtained from study patients, two to three millilitres of whole blood, nasopharyngeal and oropharyngeal swab samples, were collected for screening of Plasmodium falciparum using malaria rapid diagnostic test, microscopy and nested PCR, and SARS-CoV-2 using SARS-CoV-2 antigen test and Real-time PCR, respectively. The plasma and whole blood were also used for COVID-19 antibody testing and full blood counts using hematological analyser. SARS-CoV-2 whole genome sequencing was performed using MinIon sequencing. RESULTS The prevalence of malaria by microscopy, RDT and nested PCR were 2.3%, 2.3% and 2.7% respectively. The detection of SARS-CoV-2 by COVID-19 Rapid Antigen Test and Real-time PCR were 8.7% and 20% respectively. The Delta variant was reported in 23 of 25 SARS-CoV-2 positives with CT values below 30. Headache was the most common symptom presented by study participants (95%). Comorbidities reported were hypertension, asthma and diabetes. One hundred and thirteen (37.8%) of the study participants had prior exposure to SARS CoV-2 and (34/51) 66.7% of Astrazeneca vaccinated patients had no IgG antibody. CONCLUSION It may be difficult to use clinical characteristics to distinguish between patients with COVID-19 having malaria-like symptoms. Detection of IgM using RDTs may be useful in predicting CT values for SARS-CoV-2 real-time PCR and therefore transmission.
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Affiliation(s)
- Issabella Asamoah
- Department of Medical Microbiology, University of Ghana Medical School, University of Ghana, Korle-Bu, Accra, Ghana
| | - Mildred Adusei-Poku
- Department of Medical Microbiology, University of Ghana Medical School, University of Ghana, Korle-Bu, Accra, Ghana
| | - Priscilla Vandyck-Sey
- Korle Bu Polyclinic Family Medicine Department, Korle Bu Teaching Hospital, Accra, Ghana
| | - Allen Steele-Dadzie
- Korle Bu Polyclinic Family Medicine Department, Korle Bu Teaching Hospital, Accra, Ghana
| | - Atta Senior Kuffour
- Department of Medical Microbiology, University of Ghana Medical School, University of Ghana, Korle-Bu, Accra, Ghana
| | - Albert Turkson
- Department of Medical Microbiology, University of Ghana Medical School, University of Ghana, Korle-Bu, Accra, Ghana
| | - Ivy Asantewaa Asante
- Department of Virology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Kantanka Addo-Osafo
- Department of Medical Microbiology, University of Ghana Medical School, University of Ghana, Korle-Bu, Accra, Ghana
| | - Quaneeta Mohktar
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Bright Adu
- Department of Immunology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Yaw A. Afrane
- Department of Medical Microbiology, University of Ghana Medical School, University of Ghana, Korle-Bu, Accra, Ghana
| | - Kwamena W. C. Sagoe
- Department of Medical Microbiology, University of Ghana Medical School, University of Ghana, Korle-Bu, Accra, Ghana
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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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Shih DC, Silver R, Henao OL, Alemu A, Audi A, Bigogo G, Colston JM, Edu-Quansah EP, Erickson TA, Gashu A, Gbelee GB, Gunter SM, Kosek MN, Logan GG, Mackey JM, Maliga A, Manzanero R, Morazan G, Morey F, Munoz FM, Murray KO, Nelson TV, Olortegui MP, Yori PP, Ronca SE, Schiaffino F, Tayachew A, Tedasse M, Wossen M, Allen DR, Angra P, Balish A, Farron M, Guerra M, Herman-Roloff A, Hicks VJ, Hunsperger E, Kazazian L, Mikoleit M, Munyua P, Munywoki PK, Namwase AS, Onyango CO, Park M, Peruski LF, Sugerman DE, Gutierrez EZ, Cohen AL. Incorporating COVID-19 into Acute Febrile Illness Surveillance Systems, Belize, Kenya, Ethiopia, Peru, and Liberia, 2020-2021. Emerg Infect Dis 2022; 28:S34-S41. [PMID: 36502419 DOI: 10.3201/eid2813.220898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Existing acute febrile illness (AFI) surveillance systems can be leveraged to identify and characterize emerging pathogens, such as SARS-CoV-2, which causes COVID-19. The US Centers for Disease Control and Prevention collaborated with ministries of health and implementing partners in Belize, Ethiopia, Kenya, Liberia, and Peru to adapt AFI surveillance systems to generate COVID-19 response information. Staff at sentinel sites collected epidemiologic data from persons meeting AFI criteria and specimens for SARS-CoV-2 testing. A total of 5,501 patients with AFI were enrolled during March 2020-October 2021; >69% underwent SARS-CoV-2 testing. Percentage positivity for SARS-CoV-2 ranged from 4% (87/2,151, Kenya) to 19% (22/115, Ethiopia). We show SARS-CoV-2 testing was successfully integrated into AFI surveillance in 5 low- to middle-income countries to detect COVID-19 within AFI care-seeking populations. AFI surveillance systems can be used to build capacity to detect and respond to both emerging and endemic infectious disease threats.
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Konozy EHE, Osman MEFM, Ghartey-Kwansah G, Abushama HM. The striking mimics between COVID-19 and malaria: A review. Front Immunol 2022; 13:957913. [PMID: 36081516 PMCID: PMC9445119 DOI: 10.3389/fimmu.2022.957913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 08/04/2022] [Indexed: 11/25/2022] Open
Abstract
Objectives COVID-19 is a transmissible illness triggered by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Since its onset in late 2019 in Wuhan city of China, it continues to spread universally, leading to an ongoing pandemic that shattered all efforts to restrain it. On the other hand, in Africa, the COVID-19 infection may be influenced by malaria coinfection. Hence, in this review article, we aimed to give a comprehensive account of the similarities between COVID-19 and malaria in terms of symptoms, clinical, immunological, and molecular perspectives. Methodology In this article, we reviewed over 50 research papers to highlight the multilayered similarities between COVID-19 and malaria infections that might influence the ontology of COVID-19. Results Despite the poor health and fragile medical system of many sub-Saharan African countries, they persisted with a statistically significantly low number of COVID-19 cases. This was attributed to many factors such as the young population age, the warm weather, the lack of proper diagnosis, previous infection with malaria, the use of antimalarial drugs, etc. Additionally, population genetics appears to play a significant role in shaping the COVID-19 dynamics. This is evident as recent genomic screening analyses of the angiotensin-converting enzyme 2 (ACE2) and malaria-associated-variants identified 6 candidate genes that might play a role in malaria and COVID-19 incidence and severity. Moreover, the clinical and pathological resemblances between the two diseases have made considerable confusion in the diagnosis and thereafter curb the disease in Africa. Therefore, possible similarities between the diseases in regards to the clinical, pathological, immunological, and genetical ascription were discussed. Conclusion Understanding the dynamics of COVID-19 infection in Sub-Saharan Africa and how it is shaped by another endemic disease like malaria can provide insights into how to tailor a successful diagnostic, intervention, and control plans that lower both disease morbidity and mortality.
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Affiliation(s)
| | | | - George Ghartey-Kwansah
- Department of Biomedical Sciences, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
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Boonyarangka P, Phontham K, Sriwichai S, Poramathikul K, Harncharoenkul K, Kuntawunginn W, Maneesrikhum N, Srisawath S, Seenuan C, Thanyakait C, Inkabajan K, Pludpiem S, Pidtana K, Demons S, Vesely B, Wojnarski M, Griesenbeck JS, Spring M. Co-Infection with Plasmodium vivax and COVID-19 in Thailand. Trop Med Infect Dis 2022; 7:tropicalmed7080145. [PMID: 35893653 PMCID: PMC9332623 DOI: 10.3390/tropicalmed7080145] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 07/15/2022] [Accepted: 07/18/2022] [Indexed: 02/06/2023] Open
Abstract
With the emergence of SARS-CoV-2, healthcare systems not only had to address the pressing clinical needs of the COVID-19 pandemic but anticipate the effect on and of other conditions and diseases. This was of particular concern in areas of the world endemic with malaria, a disease which takes hundreds of thousands of lives each year. This case report from Thailand describes a 25-year-old man diagnosed with Plasmodium vivax, who was then found to be co-infected with COVID-19. Both conditions can have overlapping acute febrile illness symptoms which may delay or complicate diagnoses. He had no prior history of malaria and had received two vaccinations against COVID-19. His clinical course was mild with no pulmonary complications or oxygen requirement, and he responded well to treatments for both conditions. Three months after cure, he again contracted COVID-19 but did not experience any P. vivax relapse. Review of the available literature produced less than 10 publications describing co-infections with P. vivax and COVID-19; nonetheless, in endemic areas, vigilance for both diseases should continue, as co-infections could significantly alter the course of clinical management and prognosis as well as affect the healthcare staff caring for these patients.
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Affiliation(s)
- Parat Boonyarangka
- Department of Bacterial and Parasitic Diseases, US Army Armed Forces Research Institute of Medical Sciences, Bangkok 10400, Thailand; (P.B.); (K.P.); (S.S.); (K.P.); (K.H.); (W.K.); (K.P.); (S.D.); (B.V.); (M.W.); (J.S.G.)
| | - Kittijarankon Phontham
- Department of Bacterial and Parasitic Diseases, US Army Armed Forces Research Institute of Medical Sciences, Bangkok 10400, Thailand; (P.B.); (K.P.); (S.S.); (K.P.); (K.H.); (W.K.); (K.P.); (S.D.); (B.V.); (M.W.); (J.S.G.)
| | - Sabaithip Sriwichai
- Department of Bacterial and Parasitic Diseases, US Army Armed Forces Research Institute of Medical Sciences, Bangkok 10400, Thailand; (P.B.); (K.P.); (S.S.); (K.P.); (K.H.); (W.K.); (K.P.); (S.D.); (B.V.); (M.W.); (J.S.G.)
| | - Kamonporn Poramathikul
- Department of Bacterial and Parasitic Diseases, US Army Armed Forces Research Institute of Medical Sciences, Bangkok 10400, Thailand; (P.B.); (K.P.); (S.S.); (K.P.); (K.H.); (W.K.); (K.P.); (S.D.); (B.V.); (M.W.); (J.S.G.)
| | - Krit Harncharoenkul
- Department of Bacterial and Parasitic Diseases, US Army Armed Forces Research Institute of Medical Sciences, Bangkok 10400, Thailand; (P.B.); (K.P.); (S.S.); (K.P.); (K.H.); (W.K.); (K.P.); (S.D.); (B.V.); (M.W.); (J.S.G.)
| | - Worachet Kuntawunginn
- Department of Bacterial and Parasitic Diseases, US Army Armed Forces Research Institute of Medical Sciences, Bangkok 10400, Thailand; (P.B.); (K.P.); (S.S.); (K.P.); (K.H.); (W.K.); (K.P.); (S.D.); (B.V.); (M.W.); (J.S.G.)
| | - Napat Maneesrikhum
- Suan Phueng Hospital, Ratchaburi 70180, Thailand; (N.M.); (S.S.); (C.S.); (C.T.); (K.I.)
| | - Sarayouth Srisawath
- Suan Phueng Hospital, Ratchaburi 70180, Thailand; (N.M.); (S.S.); (C.S.); (C.T.); (K.I.)
| | - Chanida Seenuan
- Suan Phueng Hospital, Ratchaburi 70180, Thailand; (N.M.); (S.S.); (C.S.); (C.T.); (K.I.)
| | - Chattakorn Thanyakait
- Suan Phueng Hospital, Ratchaburi 70180, Thailand; (N.M.); (S.S.); (C.S.); (C.T.); (K.I.)
| | - Kanjana Inkabajan
- Suan Phueng Hospital, Ratchaburi 70180, Thailand; (N.M.); (S.S.); (C.S.); (C.T.); (K.I.)
| | - Suda Pludpiem
- Division of Health Promotion and Prevention, Suan Phueng District Health Office, Ratchaburi 70180, Thailand;
| | - Kingkan Pidtana
- Department of Bacterial and Parasitic Diseases, US Army Armed Forces Research Institute of Medical Sciences, Bangkok 10400, Thailand; (P.B.); (K.P.); (S.S.); (K.P.); (K.H.); (W.K.); (K.P.); (S.D.); (B.V.); (M.W.); (J.S.G.)
| | - Samandra Demons
- Department of Bacterial and Parasitic Diseases, US Army Armed Forces Research Institute of Medical Sciences, Bangkok 10400, Thailand; (P.B.); (K.P.); (S.S.); (K.P.); (K.H.); (W.K.); (K.P.); (S.D.); (B.V.); (M.W.); (J.S.G.)
| | - Brian Vesely
- Department of Bacterial and Parasitic Diseases, US Army Armed Forces Research Institute of Medical Sciences, Bangkok 10400, Thailand; (P.B.); (K.P.); (S.S.); (K.P.); (K.H.); (W.K.); (K.P.); (S.D.); (B.V.); (M.W.); (J.S.G.)
| | - Mariusz Wojnarski
- Department of Bacterial and Parasitic Diseases, US Army Armed Forces Research Institute of Medical Sciences, Bangkok 10400, Thailand; (P.B.); (K.P.); (S.S.); (K.P.); (K.H.); (W.K.); (K.P.); (S.D.); (B.V.); (M.W.); (J.S.G.)
| | - John S. Griesenbeck
- Department of Bacterial and Parasitic Diseases, US Army Armed Forces Research Institute of Medical Sciences, Bangkok 10400, Thailand; (P.B.); (K.P.); (S.S.); (K.P.); (K.H.); (W.K.); (K.P.); (S.D.); (B.V.); (M.W.); (J.S.G.)
| | - Michele Spring
- Department of Bacterial and Parasitic Diseases, US Army Armed Forces Research Institute of Medical Sciences, Bangkok 10400, Thailand; (P.B.); (K.P.); (S.S.); (K.P.); (K.H.); (W.K.); (K.P.); (S.D.); (B.V.); (M.W.); (J.S.G.)
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD 20817, USA
- Correspondence:
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