Less Severe Cases of COVID-19 in Sub-Saharan Africa: Could Co-infection or a Recent History of Infection Be Protective?

Sub-Saharan Africa has generally experienced few cases and deaths of coronavirus disease 2019 (COVID-19). In addition to other potential explanations for the few cases and deaths of COVID-19 such as the population socio-demographics, early lockdown measures and the possibility of under reporting, we hypothesize in this mini review that individuals with a recent history of malaria infection may be protected against infection or severe form of COVID-19. Given that both the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and () merozoites bind to the cluster of differentiation 147 (CD147) immunoglobulin, we hypothesize that the immunological memory against merozoites primes SARS-CoV-2 infected cells for early phagocytosis, hence protecting individuals with a recent infection against COVID-19 infection or severity. This mini review therefore discusses the potential biological link between infection and COVID-19 infection or severity and further highlights the importance of CD147 immunoglobulin as an entry point for both SARS-CoV-2 and into host cells.