COVID-19 cases are less prevalent in countries where malaria is endemic, suggesting a role for anti-malarial drugs as prophylaxis

Abstract

Almost every country across the world has felt the repercussions of the pandemic of disease termed coronavirus disease 2019 (COVID-19) caused by the novel coronavirus identified as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A recently published article points to a method of prevention and prophylaxis of COVID-19 through the use of anti-malarial drugs such as the 4-aminoquinolones: chloroquine and hydroxychloroquine, based on their mechanisms of action against SARS-CoV-2. This report aims to explore the correlation between COVID-19 cases and countries where malaria is prevalent using statistical means. It is hypothesized that countries where malaria is endemic will have few cases of COVID-19 since these countries use the 4-aminoquinolone anti-malarial drugs for prophylaxis. Statistical analysis demonstrates that the numbers and incidence of COVID-19 cases and COVID-19 related deaths are substantially lower (multiple-fold lower) in countries with the highest prevalence of malaria. The difference between both the COVID-19 incidence rate and the COVID-19 mortality rate in malaria prevalent countries compared to COVID-19 prevalent countries is statistically significant (p = 0.02 and p = 0.04 respectively). This study provides further evidence that anti-malaria drugs may prove essential to breaking the spread of SARS-CoV-2 and preventing COVID-19 and COVID-19 related mortality. As the pandemic continues to evolve and doctors and researchers across the globe try to attenuate or stop the spread of SARS-CoV-2, the medical community should not overlook the potential role of the 4-aminoquinolones anti-malarial drugs, chloroquine and hydroxychloroquine, and 8-aminoquinolone anti-malaria drugs, tafenoquine and primaquine, as a prophylaxis.