COVID-19 unfolding filariasis: The first case of SARS-CoV-2 and Wuchereria bancrofti coinfection

Abstract

With the evolution of the Coronavirus Disease 2019 (COVID-19) pandemic, the number of patients brought to medical attention has increased. This has led to the unmasking of many coexisting occult infections and comorbidities such as tuberculosis, dengue, human immunodeficiency viral infection, diabetes, and hypertension. We report the first case of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection, unveiling the diagnosis of asymptomatic filariasis. A 37-year-old gentleman presented with shortness of breath, fever, and cough. He was found to have COVID-19 pneumonia. During his stay, microfilaria of Wuchereria bancrofti was detected incidentally on a blood smear exam. Consequently, the patient received appropriate treatment for both conditions. In order not to miss relevant concomitant diagnoses, it is prudent to keep a broad differential diagnosis when faced with SARS-CoV-2–infected patients; this is especially true when atypical symptoms are present or in areas endemic with other infections.

The impact of COVID-19 on neglected parasitic diseases: what to expect?

“…In this case, a blood smear sample was collected from a 37-year-old south Asian man with COVID-19 pneumonia; he had no symptoms of filariasis despite the presence of Wuchereria bancrofti microfilaria. It is important to emphasize in such cases that mixed infections should be suspected during clinical examinations, and that routine laboratory tests should be carried out in order to allow proper disease monitoring in endemic regions [8].…”

The Complexity of Co-Infections in the Era of COVID-19

“…Given the global reality of the pandemic, and regardless of seasonality, co-infections are seen among patients with unique non-viral infections. Reports have been made of SARS-CoV-2 infection complicating parasitic diseases [83][84][85]. Intestinal parasite co-infection however was seemingly associated with less severe COVID-19 [86].…”

The New Status of Parasitic Diseases in the COVID-19 Pandemic—Risk Factors or Protective Agents?

“…Similarly, an inverse relationship has been reported between the number of cases of certain neglected tropical diseases and those of COVID-19 [ 73 ], with one study suggesting that malaria may offer a protective effect against SARS-CoV-2 [ 30 ]. Moreover, in patients with SARS-CoV-2 and Wuchereria bancrofti co-infection, T cell hypoactivation may cause a relatively milder course of COVID-19 [ 6 ].…”

“…Not only can parasite infections influence the immune system, destroy tissue, cause anemia and malnutrition, they can also potentially support virus infection [ 2 , 3 ] and affect the effectiveness of vaccines [ 4 , 5 ]. However, parasitic immunomodulation may also protect from tissue damage by reducing inflammatory processes [ 6 ]. The present study therefore discusses how parasites may act as risk factors or protective agents in the COVID-19 pandemic and, conversely, how the pandemic may affect the diagnosis and prevention of parasitic diseases ( Figure 1 ).…”