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BMC Infectious Diseases

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Open Access 01-12-2022 | Malaria | Research

Low incidence of COVID-19 case severity and mortality in Africa; Could malaria co-infection provide the missing link?

Authors: Silas Acheampong Osei, Robert Peter Biney, Alberta Serwah Anning, Lydia Nkuah Nortey, George Ghartey-Kwansah

Published in: BMC Infectious Diseases | Issue 1/2022

Abstract

Background

Despite reports of malaria and coronavirus diseases 2019 (COVID-19) co-infection, malaria-endemic regions have so far recorded fewer cases of COVID-19 and deaths from COVID-19, indicating a probable protection from the poor outcome of COVID-19 by malaria. On the contrary, other evidence suggests that malaria might contribute to the death caused by COVID-19. Hence, this paper reviewed existing evidence hypothesizing poor outcome or protection of COVID-19 patients when co-infected with malaria.

Methods

PRISMA guidelines for systematic review were employed in this study. Published articles from December 2019 to May 2021on COVID-19 and malaria co-infection and outcome were systematically searched in relevant and accessible databases following a pre-defined strategy. Studies involving human, in vivo animal studies, and in vitro studies were included.

Results

Twenty three (23) studies were included in the review out of the 3866 records identified in the selected scientific databases. Nine (9) papers reported on co-infection of COVID-19 and malaria. Five (5) papers provided information about synergism of malaria and COVID-19 poor prognosis, 2 papers reported on syndemic of COVID-19 and malaria intervention, and 7 studies indicated that malaria protects individuals from COVID-19.

Conclusions

Low incidence of COVID-19 in malaria-endemic regions supports the hypothesis that COVID-19 poor prognosis is prevented by malaria. Although further studies are required to ascertain this hypothesis, cross-immunity and common immunodominant isotopes provide strong evidence to support this hypothesis. Also, increase in co-inhibitory receptors and atypical memory B cells indicate synergy between COVID-19 and malaria outcome, though, more studies are required to make a definite conclusion.

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Title: Low incidence of COVID-19 case severity and mortality in Africa; Could malaria co-infection provide the missing link?
Authors: Silas Acheampong Osei
Robert Peter Biney
Alberta Serwah Anning
Lydia Nkuah Nortey
George Ghartey-Kwansah
Publication date: 01-12-2022
Publisher: BioMed Central
Keywords: Malaria
Antimalaria
SARS-CoV-2
COVID-19
Published in: BMC Infectious Diseases / Issue 1/2022
Electronic ISSN: 1471-2334
DOI: https://doi.org/10.1186/s12879-022-07064-4

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