Abstract
BackgroundBy 27 June 2020, almost half a million people had died due to COVID-19 infections. The susceptibility and severity of infection vary significantly across nations. The contribution of chronic viral and parasitic infections to immune homeostasis remains a concern. By investigating the role of interferon (IFN)-γ, we conducted this study to understand the connection between the decrease in numbers and severity of COVID-19 cases within parasitic endemic regions. Our research included 375 patients referred to hospitals for diagnosis of COVID-19 infection. Patients were subjected to full investigations, in particular severe acute respiratory syndrome coronavirus-2 nucleic acid and Toxoplasma IgM and IgG antibody detection, stool examination, and quantitative IFN-γ measurement.ResultsThe majority of the studied cases had chest manifestation either alone (54.7%) or in association with gastrointestinal (GIT) manifestations (19.7%), whereas 25.6% had GIT symptoms. We reported parasitic infections in 72.8% of mild COVID-19 cases and 20.7% of severe cases. Toxoplasma gondii, Cryptosporidium, Blastocyst, and Giardia were the most common parasitic infections among the COVID-19 cases studied.ConclusionThe remarkable adaptation of human immune response to COVID-19 infection by parasitic infections with high levels of IFN-γ was observed in moderate cases compared with low levels in extreme cases. The potential therapeutic efforts aimed at the role of parasitic infection in immune system modulation are needed if this hypothesis is confirmed.
Highlights
Severe acute respiratory syndrome coronavirus-2 (SARSCoV-2) is an intercontinental pandemic triggered by the universal human-to-human transmission of the virus [1]
This research included 375 patients diagnosed with COVID-19 positive (+ ve) via PCR tests
A high percentage of moderate COVID cases accompanied with parasitic infections was observed in our results, and an increased number of serious cases were parasite free
Summary
Severe acute respiratory syndrome coronavirus-2 (SARSCoV-2) is an intercontinental pandemic triggered by the universal human-to-human transmission of the virus [1]. Malaria-endemic countries have reported a low number of COVID-19 cases [3]. The populations in these areas have natural protection against malaria infection by producing a combination of Th1 and Th2 responses. Malaria-induced immunosuppression severely inhibits immune responses to other infections, such as Salmonella spp. By investigating the role of interferon (IFN)-γ, we conducted this study to understand the connection between the decrease in numbers and severity of COVID-19 cases within parasitic endemic regions. Patients were subjected to full investigations, in particular severe acute respiratory syndrome coronavirus-2 nucleic acid and Toxoplasma IgM and IgG antibody detection, stool examination, and quantitative IFN-γ measurement
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