COVID-19 and Parasitic Co-Infection: A Hypothetical Link to Pulmonary Vascular Disease
Peter S Nyasulu1, Jacques L Tamuzi1, Rudolf K F Oliveira1
1Division of Epidemiology & Biostatistics, Department of Global Health, Faculty of Medicine & Health Sciences, Stellenbosch University, France Van Zijl Drive, Tygerberg, Cape Town 7505, South Africa.
Insights
COVID-19 and parasitic co-infections may increase the risk of pulmonary vascular disease (PVD). Further research is needed to understand the complex pathophysiological links and future impact on PVD mortality and morbidity.
Area of Science:
- Medical Research
- Infectious Diseases
- Pulmonology
Background:
- Pulmonary arterial hypertension (PAH) prevalence was historically low (0.4-1.4 per 100,000).
- COVID-19 and its co-infections may elevate the risk of pulmonary vascular disease (PVD).
- Preliminary data suggests 22% of severe COVID-19 patients may develop PVD, but predictive value is unknown.
Purpose of the Study:
- To review the potential link between COVID-19, parasitic co-infections, and PVD.
- To explore hypothetical pathophysiological mechanisms connecting these conditions.
- To assess the potential future impact of PVD on mortality and morbidity.
Main Methods:
- Systematic literature review (SLR) of peer-reviewed articles.
- Focused on studies linking COVID-19, parasitic co-infection, and PVD.
- Included analysis of hypothetical pathophysiological pathways.
Main Results:
- Hypothesized that various pathogens (schistosomiasis, HIV, PTB, etc.) combined with COVID-19 could increase PVD burden.
- Identified potential for worsened PVD mortality and morbidity in the future.
- Highlighted understudied nature of PVD from COVID-19 co-infections.
Conclusions:
- COVID-19 and parasitic co-infections may synergistically contribute to PVD development and progression.
- Further experimental studies are crucial to elucidate the precise pathophysiological mechanisms.
- Understanding these pathways is vital for predicting and managing future PVD cases.
Abstract:
Background/Objectives: Before the Coronavirus disease 2019 (COVID-19) era, the global prevalence of pulmonary arterial hypertension (PAH) was between 0.4 and 1.4 per 100,000 people. The long-term effects of protracted COVID-19 associated with pulmonary vascular disease (PVD) risk factors may increase this prevalence. According to preliminary data, the exact prevalence of early estimates places the prevalence of PVD in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection at 22%, although its predictive value remains unknown. PVD caused by COVID-19 co-infections is understudied and underreported, and its future impact is unclear. However, due to COVID-19/co-infection pathophysiological effects on pulmonary vascularization, PVD mortality and morbidity may impose a genuine concern-both now and in the near future. Based on reported studies, this literature review focused on the potential link between COVID-19, parasitic co-infection, and PVD. This review article also highlights hypothetical pathophysiological mechanisms between COVID-19 and parasitic co-infection that could trigger PVD. Methods: We conducted a systematic literature review (SLR) searching peer-reviewed articles, including link between COVID-19, parasitic co-infection, and PVD. Results: This review hypothesized that multiple pathways associated with pathogens such as underlying schistosomiasis, human immunodeficiency virus (HIV), pulmonary tuberculosis (PTB), pulmonary aspergillosis, Wuchereria bancrofti, Clonorchis sinensis, paracoccidioidomycosis, human herpesvirus 8, and scrub typhus coupled with acute or long COVID-19, may increase the burden of PVD and worsen its mortality in the future. Conclusions: Further experimental studies are also needed to determine pathophysiological pathways between PVD and a history of COVID-19/co-infections.
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