Universal COVID-19 Treatment Centre, Ministry of Health, Khartoum State, Sudan; Ministry of Health, Khartoum State, Sudan; School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil; Soba University Hospital, Khartoum, Sudan.
School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil.
Clin Microbiol Infect. 2022 Aug;28(8):1152.e1-1152.e6. doi: 10.1016/j.cmi.2022.03.028. Epub 2022 Mar 31.
Despite the possibility of concurrent infection with COVID-19 and malaria, little is known about the clinical course of coinfected patients. We analysed the clinical outcomes of patients with concurrent COVID-19 and malaria infection.
We conducted a retrospective cohort study that assessed prospectively collected data of all patients who were admitted between May and December 2020 to the Universal COVID-19 treatment center (UCTC), Khartoum, Sudan. UCTC compiled demographic, clinical, laboratory (including testing for malaria), and outcome data in all patients with confirmed COVID-19 hospitalized at that clinic. The primary outcome was all-cause mortality during the hospital stay. We built proportional hazard Cox models with malaria status as the main exposure and stepwise adjustment for age, sex, cardiovascular comorbidities, diabetes, and hypertension.
We included 591 patients with confirmed COVID-19 diagnosis who were also tested for malaria. Mean (SD) age was 58 (16.2) years, 446/591 (75.5%) were males. Malaria was diagnosed in 270/591 (45.7%) patients. Most malaria patients were infected by Plasmodium falciparum (140/270; 51.9%), while 121/270 (44.8%) were coinfected with Plasmodium falciparum and Plasmodium vivax. Median follow-up was 29 days. Crude mortality rates were 10.71 and 5.87 per 1000 person-days for patients with and without concurrent malaria, respectively. In the fully adjusted Cox model, patients with concurrent malaria and COVID-19 had a greater mortality risk (hazard ratio 1.43, 95% confidence interval 1.21-1.69).
Coinfection with COVID-19 and malaria is associated with increased all-cause in-hospital mortality compared to monoinfection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
尽管 COVID-19 和疟疾可能同时感染，但对于合并感染患者的临床病程知之甚少。我们分析了合并 COVID-19 和疟疾感染患者的临床结局。
我们进行了一项回顾性队列研究，评估了 2020 年 5 月至 12 月期间在苏丹喀土穆的通用 COVID-19 治疗中心（UCTC）住院的所有患者前瞻性收集的数据。UCTC 在该诊所住院的所有确诊 COVID-19 患者中编制了人口统计学、临床、实验室（包括疟疾检测）和结局数据。主要结局是住院期间的全因死亡率。我们构建了比例风险 Cox 模型，以疟疾状况为主要暴露因素，并逐步调整年龄、性别、心血管合并症、糖尿病和高血压。
我们纳入了 591 例确诊 COVID-19 诊断并接受疟疾检测的患者。平均（标准差）年龄为 58（16.2）岁，446/591（75.5%）为男性。591 例患者中诊断出 270/591（45.7%）例疟疾。大多数疟疾患者感染了恶性疟原虫（140/270；51.9%），而 121/270（44.8%）合并感染恶性疟原虫和间日疟原虫。中位随访时间为 29 天。疟疾患者和无疟疾患者的粗死亡率分别为每 1000 人-日 10.71 和 5.87 人。在完全调整的 Cox 模型中，合并感染 COVID-19 和疟疾的患者死亡风险更高（危险比 1.43，95%置信区间 1.21-1.69）。
与单纯感染严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）相比，合并感染 COVID-19 和疟疾与住院全因死亡率增加相关。
