Comorbilidad enfermedad de Chagas-COVID-19. ¿Ventaja para pacientes chagásicos?

Abstract

Introduction. Chagas’s disease a neglected and debilitating tropical illness, caused by Trypanosoma cruzi-infection, afflicts millions of people in most Latin-American countries. In the same region, frequent and severe viral infection cases have been reported due to SARS-CoV-2, the causative agent of COVID-19, deemed as the worst global pandemic in the 21st century. Objective. To investigate the Chagas disease-COVID-19-relationship, and the comorbidity effect on chagasic patients living in communities where SARS-CoV-2 have circulated during the last two years causing severe cases and deaths. Material and methods. Randomly selected chagasic patients (N=50) from rural localities of western Venezuela, where COVID-19 has occurred, were evaluated in order to know whether they had suffered SARS-CoV-2- infection. COVID-infected chagasic patients were clinically compared with non-chagasic individuals (N=22) who had suffered the viruses in the same localities. Results. SARS-CoV-2-infection caused significantly less aggressive effects in chagasic patients than in non-chagasic patients, evidenced by the short-lasting scarce mild symptoms and the attenuated clinical profile (p<0.05), without further complications. Comparison revealed COVID-19 detection in 10% of chagasic patients, showing all of them mild clinical pattern and few symptoms, while non-chagasic COVID-infected control individuals, showed 45% and 13% severe and fatal cases, respectively. Conclusion. Chagasic patients suffering from COVID-19 comorbidity seem to express a robust immune response (Th1/Th2/Th17), which associated with anti-T. cruzi-glycoproteins circulating antibodies, directed to certain SARS-CoV-2glycoproteins (membrane/spike), may induce a short lasting and milder clinical profile. More investigations in populations where Chagas disease is endemic, is recommended.