Impact of Current Malaria Infection and Previous Malaria Exposure on the Clinical Profiles and Outcome of COVID-19 in a High Malaria Transmission Setting
MetadataShow full item record
Background: Our understanding of the potential impact of SARS-CoV-2 and malaria co-infection on host susceptibility and pathogenesis remains unclear. We determined the prevalence of malaria and describe the consequences of SARS-CoV-2 and malaria co-infection in a high burden malaria setting. Methods: This was a prospective cohort study of hospitalized Covid-19 patients in Uganda. Malaria diagnosis was done using rapid diagnostic tests, microcopy and molecular methods. Previous P. falciparum exposure was assessed using serologic responses to a panel of P. falciparum antigens using a multiplex bead assay. Additional evaluations included complete blood count, markers of inflammation and serum biochemistries. Findings: Of 597 PCR confirmed Covid-19 cases enrolled between 16th April and 30th October 2020, 500 (84.1%) were male and median age (1QR) was 36 (28-47) years. Overall prevalence of P. falciparum infection was 11.7% (70/597, 95% CI 9.4 to 14.6), with highest prevalence in the 0- 20 years (21.7%, 5/23, 95% CI 8.7-44.8) and > 60 years (19.6%, 9/46, 95% CI 10.2-34.1) age groups. Confusion [5.7% (4/70) vs. 1.5%, (8/527), p=0.04] and vomiting [5.7% (5/70) vs.1.0%, 5/527), p=0.007] were more frequent among patients with P. falciparum infection. Patients with low previous P. falciparum exposure had a higher frequency of severe/critical Covid-19 cases (30.2%, 16/53, p=0.001), a higher burden of comorbidities [hypertension (30.2%, 16/53, p=0.02) and diabetes (22.6%, 12/53, p=0.003)] and more deaths (3.8%, 2/53, p=0.01). Among patients with no comorbidities, those with low previous exposure still had a higher proportion of severe/critical Covid-19 cases (18.2%, 6/53 vs. 2.0%, 1/56, p=0.01) compared to those with high exposure. Interpretation: Prevalence of P. falciparum infection among Covid-19 patients was relatively high. Though Covid-19 patients with P. falciparum infection had a higher frequency of confusion and vomiting, co-infection with malaria did not seem deleterious. Low previous malaria exposure was associated with severe/critical Covid-19 and adverse outcomes. Funding: Funding: Grant from Malaria Consortium, US Declaration of Interest: HA and FN are members of the Mulago Hospital Research and Ethics but did not participate in decisions pertaining this study. All other authors declare no competing interests. Ethical Approval: The study was approved by the Mulago National Referral Hospital Research and Ethics committee and the Uganda National Council for Science and Technology.
URIhttps://ssrn.com/abstract=3844848 or http://dx.doi.org/10.2139/ssrn.3844848
- Medical and Health Sciences 
Showing items related by title, author, creator and subject.
Current malaria infection, previous malaria exposure, and clinical profiles and outcomes of COVID-19 in a setting of high malaria transmission: an exploratory cohort study in Uganda Achan, Jane (Global Technical Team, Malaria Consortium, London, UK, 2022)Background The potential effects of SARS-CoV-2 and Plasmodium falciparum co-infection on host susceptibility and pathogenesis remain unknown. We aimed to establish the prevalence of malaria and describe the clinical ch ...
Practice and prospects of indigenous homestead based approaches to prevention of malaria; a case study of a high malaria transmission area in Uganda Waako, Paul J.; Nsubuga, Rebecca N.; Sebulime, Peregrine; Tabuti, John R.S. (Scientific Research and Essays, 2010)Environmental sanitation and indigenous practices based on homestead characteristics have not been emphasized in national malaria control strategies. This study explored homestead characteristics, housing attributes, ...
Inpatient Mortality in Children With Clinically Diagnosed Malaria As Compared With Microscopically Confirmed Malaria Opoka, Robert O.; Xia, Zongqi; Bangirana, Paul; John, Chandy C. (The Pediatric infectious disease journal, 2008)Inpatient treatment for malaria without microscopic confirmation of the diagnosis occurs commonly in sub-Saharan Africa. Differences in mortality in children who are tested by microscopy for Plasmodium falciparum infection ...