Malaria and Parasitic Neglected Tropical Diseases: Potential Syndemics with COVID-19?

Abstract

The COVID-19 pandemic, caused by SARS-CoV-2, have surpassed 5 million cases globally. Current models suggest that low-and middle-income countries (LMICs) will have a similar incidence but substantially lower mortality rate than high-income countries. However, malaria and neglected tropical diseases (NTDs) are prevalent in LMICs, and coinfections are likely. Both malaria and parasitic NTDs can alter immunologic responses to other infectious agents. Malaria can induce a cytokine storm and pro-coagulant state similar to that seen in severe COVID-19. Consequently, coinfections with malaria parasites and SARS-CoV-2 could result in substantially worse outcomes than monoinfections with either pathogen, and could shift the age pattern of severe COVID-19 to younger age-groups. Enhancing surveillance platforms could provide signals that indicate whether malaria, NTDs, and COVID-19 are syndemics (synergistic epidemics). Based on the prevalence of malaria and NTDs in specific localities, efforts to characterize COVID-19 in LMICs could be expanded by adding testing for malaria and NTDs. Such additional testing would allow the determination of the rates of coinfection and comparison of severity of outcomes by infection status, greatly improving the understanding of the epidemiology of COVID-19 in LMICs and potentially helping to mitigate its impact.

Co‐infection of malaria and dengue in pregnant women with SARS‐CoV‐2

“…Many low-and middle-income countries (LMICs) experience high rates of malaria and other neglected tropical diseases (NTDs), such as dengue. 1 The COVID-19 pandemic complicates these matters further as COVID-19 in pregnant women is associated with an increased risk of preterm birth, and in some LMICs it is associated with a higher risk of maternal death. 2 whereas they may be presentations of dengue or malaria, which T A B L E 1 Socio-demographic, clinical characteristics, and treatment of pregnant women with COVID-19 and dengue/malaria.…”

Malaria and COVID-19: Common and Different Findings

“…Moreover, the similar and generic symptoms make it harder to achieve an immediate diagnosis. Healthcare systems and professionals will face a great challenge in case of a syndemic [ 56 , 57 ]. The role of young health professionals, well-motivated and trained in primary care, will also be essential [ 58 ] in countries with a high burden of malaria.…”

Cancer vs. SARS-CoV-2 induced inflammation, overlapping functions, and pharmacological targeting

“…Malaria can also induce cytokine storm. Hence antimalarial drugs may be effective against inflammation induced during COVID-19 (Gutman et al 2020 ). It has been reviewed in previous sections how antimalarial drugs can work against COVID-19.…”