Abdel-Hamed Enas Fakhry, Ibrahim Mohamed N, Mostafa Nahed E, Moawad Howayda S F, Elgammal Nahla E, Darwiesh Ehab M, El-Rafey Dina S, ElBadawy Nissreen E, Al-Khoufi Emad Ali, Hindawi Salwa I
Medical Parasitology Department, Faculty of Medicine, Zagazig University, El Kawmia Square, Zagazig, 44511, Sharkia Governorate, Egypt.
Clinical Laboratories Department, College of Applied Medical Sciences, Jouf University, Al-Jouf, 77451, Saudi Arabia.
Gut Pathog. 2021 May 4;13(1):29. doi: 10.1186/s13099-021-00427-3.
By 27 June 2020, almost half a million people had died due to COVID-19 infections. The susceptibility and severity of infection vary significantly across nations. The contribution of chronic viral and parasitic infections to immune homeostasis remains a concern. By investigating the role of interferon (IFN)-γ, we conducted this study to understand the connection between the decrease in numbers and severity of COVID-19 cases within parasitic endemic regions. Our research included 375 patients referred to hospitals for diagnosis of COVID-19 infection. Patients were subjected to full investigations, in particular severe acute respiratory syndrome coronavirus-2 nucleic acid and Toxoplasma IgM and IgG antibody detection, stool examination, and quantitative IFN-γ measurement.
The majority of the studied cases had chest manifestation either alone (54.7%) or in association with gastrointestinal (GIT) manifestations (19.7%), whereas 25.6% had GIT symptoms. We reported parasitic infections in 72.8% of mild COVID-19 cases and 20.7% of severe cases. Toxoplasma gondii, Cryptosporidium, Blastocyst, and Giardia were the most common parasitic infections among the COVID-19 cases studied.
The remarkable adaptation of human immune response to COVID-19 infection by parasitic infections with high levels of IFN-γ was observed in moderate cases compared with low levels in extreme cases. The potential therapeutic efforts aimed at the role of parasitic infection in immune system modulation are needed if this hypothesis is confirmed.
截至2020年6月27日，近50万人死于新冠病毒感染。各国感染的易感性和严重程度差异显著。慢性病毒和寄生虫感染对免疫稳态的影响仍令人担忧。通过研究干扰素（IFN）-γ的作用，我们开展了本研究，以了解寄生虫流行地区新冠病毒感染病例数量减少与严重程度之间的联系。我们的研究纳入了375名因新冠病毒感染到医院就诊的患者。对患者进行了全面检查，尤其包括严重急性呼吸综合征冠状病毒2核酸检测、弓形虫IgM和IgG抗体检测、粪便检查以及干扰素-γ定量检测。
大多数研究病例单独出现胸部表现（54.7%）或伴有胃肠道（GIT）表现（19.7%），而25.6%有GIT症状。我们报告，72.8%的轻症新冠病毒感染病例和20.7%的重症病例存在寄生虫感染。弓形虫、隐孢子虫、芽囊原虫和贾第虫是所研究的新冠病毒感染病例中最常见的寄生虫感染。
与极端病例中低水平的干扰素-γ相比，在中度病例中观察到寄生感染通过高水平的干扰素-γ对人类免疫反应对新冠病毒感染的显著适应性。如果这一假设得到证实，需要针对寄生感染在免疫系统调节中的作用进行潜在的治疗研究。
