Abstract
Chagas disease is considered a neglected tropical disease. The acute phase of Chagas disease is characterized by several symptoms: fever, fatigue, body aches, headache and cardiopathy's. Chronic phase could be asymptomatic or symptomatic with cardiac compromise. Since the emergence of the pandemic caused by the SARS-CoV-2 virus, the cardiovascular involvement has been identified as a complication commonly reported in coronavirus disease 2019 (COVID-19). Due to the lack of knowledge of the cardiac affectations that this virus could cause in patients with Chagas disease, the aim of this review is to describe the possible cardiac affectations, as well as the treatment and recommendations that patients with both infections should carry out. The authors revised the recent and relevant literature concerning the topic and discussed advances and limitations of studies on COVID-19 and their impact in Chagas disease patients, principally with cardiac affectations. There currently exists little information about the consequences that Chagas disease patients can suffer when they are infected with COVID-19. This review highlights the emerging challenges of access to medical care and future research needs in order to understand the implications that co-infections (SARS-CoV-2 or other viruses) can generate in Chagas disease-infected people.
Highlights
In addition to this situation, the following factors can be added: (i) Mexico is the country with the highest rate of obesity in people over 15 years of age of the 37 member countries of the Organization for Economic Cooperation and Development (OECD), with 73% of the population being overweight and 34% of them suffering from morbid obesity, reducing life expectancy by 4.2 years [58]; (ii) a growing elderly population with approximately 8.2% of the population over 65 years of age [59]; (iii) an annual 24% of deaths are caused by cardiovascular diseases, which may be related to the fact that 17% of the Mexican population smokes and 22.8% suffers from hypertension [60] (iv) and an estimated 30 million people are at risk of developing Chagas disease [9]
The management of both infections is of vital care and should be further studied in depth, especially for COVID-19, through constant updates of data, effects caused by both treatments and continuous contributions from experts in the field; we suggested taking into account and following the guidelines made by Zaidel E.J. et al [37], who explained in detail the aspects of etiological treatment and provided recommendations for Chagas disease in the context of COVID-19 coinfection
In the chronic phase, in which patients can develop the affectations known as megas, including chronic Chagasic cardiopathy, it is of vital importance for health agencies in each country and in Mexico to carry out identification and registration in order to understand the situation and to establish appropriate measures to reduce the risks associated with this disease and, especially, to determine how to act in the case of patients with chronic Chagas disease and who may have other comorbidities or coinfections, such as with SARS-CoV-2
Summary
Up to the 53rd epidemiological week of 2020, 391 positive cases of Chagas have been registered in Mexico (both acute and chronic forms) [12], and it is estimated that, throughout the country, 30 million people are at risk of contracting the disease due to the fact that Chagas disease is endemic in our country [9]. This combination of poverty, endemicity, vector-prone regions and vulnerable population is the main reason why we analyzed the impact of the COVID-19 pandemic on the Mexican population suffering from Chagas disease. Chagas Cardiomyopathy (CCC) and its relationship with the pathologies caused by COVID19, as well as the influence of treatment against COVID-19 in patients with Chagas disease, and some recommendations both to prevent the infection and to contend with both diseases
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