Department of Medicine, John A. Burns School of Medicine, University of Hawai'i, Honolulu, Hawaii.
Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Am J Trop Med Hyg. 2023 Mar 20;108(5):901-905. doi: 10.4269/ajtmh.22-0671. Print 2023 May 3.
The clinical impact of Strongyloides stercoralis hyperinfection secondary to immunosuppressive therapy for coronavirus disease 2019 (COVID-19) has been an emerging topic of interest, although characteristics of Strongyloides infection in COVID-19 patients are not yet well characterized. This study summarizes the existing evidence of Strongyloides infection in COVID-19 patients and recommends future areas of research. According to the PRISMA Extension for Scoping Reviews, we performed a search on MEDLINE and EMBASE for articles with keywords including "Strongyloides," "Strongyloidiasis," and "COVID-19" from the inception of these databases to June 5, 2022. A total of 104 articles were found. After excluding duplication and thorough reviews, 11 articles, including two observational studies, one conference abstract, and nine case reports or series, were included. Two observational studies focused on revealing the prevalence of Strongyloides screening in COVID-19 patients and clinical follow-up. Among the included cases, patients were mostly from low- or middle-income countries and suffered from severe or critical COVID-19. Strongyloides hyperinfection and disseminated infection were reported in 60% and 20%, respectively. Interestingly, 40% did not have eosinophilia, a hallmark of parasitic infection, potentially leading to delay in diagnosis of strongyloidiasis. This systematic review summarizes the clinical characteristics of strongyloidiasis in COVID-19 infection. Although further studies to identify risks and precipitants associated with the onset of strongyloidiasis are crucial, increased awareness of the critical condition is warranted.
免疫抑制治疗 2019 冠状病毒病（COVID-19）继发的粪类圆线虫重度感染的临床影响已成为一个新兴的研究课题，尽管 COVID-19 患者中粪类圆线虫感染的特征尚不清楚。本研究总结了 COVID-19 患者中粪类圆线虫感染的现有证据，并提出了未来的研究方向。根据 PRISMA 扩展的范围综述，我们在 MEDLINE 和 EMBASE 上使用包括“Strongyloides”、“Strongyloidiasis”和“COVID-19”在内的关键词进行了检索，检索范围从这些数据库建立开始到 2022 年 6 月 5 日。共发现 104 篇文章。在排除重复项并进行彻底审查后，纳入了 11 篇文章，包括两项观察性研究、一篇会议摘要和九篇病例报告或系列。两项观察性研究主要侧重于揭示 COVID-19 患者中粪类圆线虫筛查的流行情况和临床随访情况。在纳入的病例中，患者大多来自中低收入国家，患有严重或危重症 COVID-19。报道了 60%的粪类圆线虫重度感染和 20%的播散性感染。有趣的是，40%的患者没有寄生虫感染的特征性标志——嗜酸性粒细胞增多，这可能导致粪类圆线虫病的诊断延迟。本系统综述总结了 COVID-19 感染中粪类圆线虫病的临床特征。虽然确定与粪类圆线虫病发病相关的风险因素和诱发因素的进一步研究至关重要，但有必要提高对这种危急情况的认识。
