Plasmodium vivax and SARS-CoV-2 co-infection in Venezuelan pregnant women: a case series

Abstract Background Malaria‐endemic areas are not spared from the impact of coronavirus disease 2019 (COVID-19), leading to co-infection scenarios where overlapping symptoms impose serious diagnostic challenges. Current knowledge on Plasmodium spp. and severe acute respiratory syndrome coronavirus 2...

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Main Authors: Fhabián S. Carrión-Nessi, Daniela L. Mendoza-Millán, Óscar D. Omaña-Ávila, Sinibaldo R. Romero, Augusto Moncada-Ortega, Mary Lopez-Perez, Jaime R. Torres, Óscar Noya-González, David A. Forero-Peña
Format: Article
Language:English
Published: BMC 2023-01-01
Series:Malaria Journal
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Online Access:https://doi.org/10.1186/s12936-023-04442-4
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author Fhabián S. Carrión-Nessi
Daniela L. Mendoza-Millán
Óscar D. Omaña-Ávila
Sinibaldo R. Romero
Augusto Moncada-Ortega
Mary Lopez-Perez
Jaime R. Torres
Óscar Noya-González
David A. Forero-Peña
author_facet Fhabián S. Carrión-Nessi
Daniela L. Mendoza-Millán
Óscar D. Omaña-Ávila
Sinibaldo R. Romero
Augusto Moncada-Ortega
Mary Lopez-Perez
Jaime R. Torres
Óscar Noya-González
David A. Forero-Peña
author_sort Fhabián S. Carrión-Nessi
collection DOAJ
description Abstract Background Malaria‐endemic areas are not spared from the impact of coronavirus disease 2019 (COVID-19), leading to co-infection scenarios where overlapping symptoms impose serious diagnostic challenges. Current knowledge on Plasmodium spp. and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) co‐infection in pregnant women remains limited, especially in Latin America, where Plasmodium vivax infection is highly prevalent. Methods This is a case series of five pregnant women with P. vivax and SARS-CoV-2 co-infection hospitalized in two main malaria referral centers of the Capital District and Bolivar state, Venezuela between March 13, 2020 and December 31, 2021. Results Clinical and laboratory data from five pregnant women with a mean age of 22 years were analyzed; three of them were in the third trimester of pregnancy. Comorbidities included obesity in two cases, hypertension in one, and asthma in one. Three out of five patients had severe to critical COVID-19 disease. Dry cough, fever, chills, and headache were the most frequent symptoms reported. Laboratory analyses showed elevated aspartate/alanine aminotransferase and creatinine levels, thrombocytopenia, and severe anemia as the most relevant abnormalities. The mean period between symptom onset and a positive molecular test for SARS-CoV-2 infection or positive microscopy for Plasmodium spp. was 4.8 ± 2.5 days and 2.8 ± 1.6 days, respectively. The mean hospital stay was 5.4 ± 7 days. Three women recovered and were discharged from the hospital. Two women died, one from cerebral malaria and one from respiratory failure. Three adverse fetal outcomes were registered, two miscarriages and one stillbirth. Conclusion This study documented a predominance of severe/critical COVID-19 disease and a high proportion of adverse maternal–fetal outcomes among pregnant women with malaria and COVID-19 co-infection. More comprehensive prospective cohort studies are warranted to explore the risk factors, management challenges, and clinical outcomes of pregnant women with this co-infection.
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spelling doaj.art-72e4cc42a5b04bfe8bc06f8521db3f122023-01-08T12:05:23ZengBMCMalaria Journal1475-28752023-01-012211610.1186/s12936-023-04442-4Plasmodium vivax and SARS-CoV-2 co-infection in Venezuelan pregnant women: a case seriesFhabián S. Carrión-Nessi0Daniela L. Mendoza-Millán1Óscar D. Omaña-Ávila2Sinibaldo R. Romero3Augusto Moncada-Ortega4Mary Lopez-Perez5Jaime R. Torres6Óscar Noya-González7David A. Forero-Peña8Biomedical Research and Therapeutic Vaccines InstituteBiomedical Research and Therapeutic Vaccines InstituteBiomedical Research and Therapeutic Vaccines InstituteBiomedical Research and Therapeutic Vaccines InstituteBiomedical Research and Therapeutic Vaccines InstituteCentre for Medical Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of CopenhagenInfectious Diseases Section, “Dr. Félix Pifano” Tropical Medicine Institute, Central University of VenezuelaInfectious Diseases Section, “Dr. Félix Pifano” Tropical Medicine Institute, Central University of VenezuelaBiomedical Research and Therapeutic Vaccines InstituteAbstract Background Malaria‐endemic areas are not spared from the impact of coronavirus disease 2019 (COVID-19), leading to co-infection scenarios where overlapping symptoms impose serious diagnostic challenges. Current knowledge on Plasmodium spp. and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) co‐infection in pregnant women remains limited, especially in Latin America, where Plasmodium vivax infection is highly prevalent. Methods This is a case series of five pregnant women with P. vivax and SARS-CoV-2 co-infection hospitalized in two main malaria referral centers of the Capital District and Bolivar state, Venezuela between March 13, 2020 and December 31, 2021. Results Clinical and laboratory data from five pregnant women with a mean age of 22 years were analyzed; three of them were in the third trimester of pregnancy. Comorbidities included obesity in two cases, hypertension in one, and asthma in one. Three out of five patients had severe to critical COVID-19 disease. Dry cough, fever, chills, and headache were the most frequent symptoms reported. Laboratory analyses showed elevated aspartate/alanine aminotransferase and creatinine levels, thrombocytopenia, and severe anemia as the most relevant abnormalities. The mean period between symptom onset and a positive molecular test for SARS-CoV-2 infection or positive microscopy for Plasmodium spp. was 4.8 ± 2.5 days and 2.8 ± 1.6 days, respectively. The mean hospital stay was 5.4 ± 7 days. Three women recovered and were discharged from the hospital. Two women died, one from cerebral malaria and one from respiratory failure. Three adverse fetal outcomes were registered, two miscarriages and one stillbirth. Conclusion This study documented a predominance of severe/critical COVID-19 disease and a high proportion of adverse maternal–fetal outcomes among pregnant women with malaria and COVID-19 co-infection. More comprehensive prospective cohort studies are warranted to explore the risk factors, management challenges, and clinical outcomes of pregnant women with this co-infection.https://doi.org/10.1186/s12936-023-04442-4Case seriesCOVID-19MalariaPlasmodium vivaxSARS-CoV-2Venezuela
spellingShingle Fhabián S. Carrión-Nessi
Daniela L. Mendoza-Millán
Óscar D. Omaña-Ávila
Sinibaldo R. Romero
Augusto Moncada-Ortega
Mary Lopez-Perez
Jaime R. Torres
Óscar Noya-González
David A. Forero-Peña
Plasmodium vivax and SARS-CoV-2 co-infection in Venezuelan pregnant women: a case series
Malaria Journal
Case series
COVID-19
Malaria
Plasmodium vivax
SARS-CoV-2
Venezuela
title Plasmodium vivax and SARS-CoV-2 co-infection in Venezuelan pregnant women: a case series
title_full Plasmodium vivax and SARS-CoV-2 co-infection in Venezuelan pregnant women: a case series
title_fullStr Plasmodium vivax and SARS-CoV-2 co-infection in Venezuelan pregnant women: a case series
title_full_unstemmed Plasmodium vivax and SARS-CoV-2 co-infection in Venezuelan pregnant women: a case series
title_short Plasmodium vivax and SARS-CoV-2 co-infection in Venezuelan pregnant women: a case series
title_sort plasmodium vivax and sars cov 2 co infection in venezuelan pregnant women a case series
topic Case series
COVID-19
Malaria
Plasmodium vivax
SARS-CoV-2
Venezuela
url https://doi.org/10.1186/s12936-023-04442-4
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