Profiles of host immune impairment in Plasmodium and SARS-CoV-2 infections.

ABSTRACT

Over the past two decades, many countries that have reported a steady decline in reported cases of malaria and a few countries like China have been declared malaria-free by the World Health Organization. In 2020, global total malaria cases 108 malaria-endemic countries as in 2000, while the number of deaths from malaria has declined since 2000. COVID-19 pandemic has adversely affected overall public health efforts and thus it is feasible that there might be resurgence of malaria. COVID-19 and malaria share some similarities in the immune responses of the patient and these two diseases also share overlapping early symptoms such as fever, headache, nausea, and muscle pain/fatigue. In the absence of early diagnostics there can be a misdiagnosis of the infection(s) that can pose additional challenges due to delayed treatment. In both SARS-CoV-2 and Plasmodium infections there is a rapid release of cytokines/chemokines that play a key role in disease pathophysiology. In this review, we have discussed the cytokine/chemokine storm observed during COVID-19 and malaria. We observe that (1) Severity in malaria and COVID-19 is likely a consequence primarily of an uncontrolled 'cytokine storm'; (2) five pro-inflammatory cytokines (IL-6, IL-10, TNF-α, type I IFN and IFN-γ) are significantly increased in severe/critically ill patients in both diseases; (3) Plasmodium and SARS-CoV-2 share some similar clinical manifestations and thus may result in fatal consequences if misdiagnosed during onset.