Abstract:
The COVID-19 pandemic linked to the virus SARS-CoV-2, which began in China, affected ∼765 million people as of 30 April 2023. The widespread use of corticosteroids for the symptomatic treatment of COVID-19 could lead to the reactivation of infections of opportunistic pathogens, including Strongyloides. We sought to determine the clinical symptoms and demographic characteristics of SARS-CoV-2-Strongyloides co-infection, particularly in patients with severe disease and being treated with immunosuppressive drugs. To do this, we undertook a systematic review of the literature, and searched public accessible scientific databases-the Web of Science, Scopus, PubMed/Medline and Embase -for eligible studies (1 December 2019 to 30 August 2022). The review protocol is registered in PROSPERO (CRD42022377062). Descriptive statistical analyses were used to present the clinical and laboratory parameters of the co-infection; for this, we calculated prevalence using the following formula: positive cases/total number of cases × 100. Of a total of 593 studies identified, 17 studies reporting 26 co-infected patients met the criteria for inclusion in this review. The median age of these patients was 55.14 years. Most of cases (53.8%) were treated with dexamethasone, followed by methylprednisolone (26.9%). Eighteen of 26 patients were immigrants living in European countries or the USA; most of these immigrants originated from Latin America (58%) and South-East Asia (11%). The commonest symptoms of co-infection were abdominal pain (50%), fever (46.1%), dyspnoea (30.7%) and cough (30.7%), and frequently reported laboratory findings were high absolute eosinophil count (38.4%), high white blood cell count (30.7%), high C-reactive protein (23.0%) and high neutrophil count (19.2%). Two of the 26 patients (7.7%) had fatal outcomes. Most of the SARS-CoV-2-Strongyloides coinfected cases were immigrants living in developed countries, emphasising the need for clinicians in these countries to be aware of clinical and laboratory parameters associated with such co-infections, as well as the key importance of rapid and accurate diagnostic tests for timely and effective diagnosis and patient management.
摘要:
COVID-19大流行与SARS-CoV-2病毒有关,该病毒始于中国,截至2023年4月30日,有7.65亿人受到影响。广泛使用皮质类固醇对症治疗COVID-19可能导致机会性病原体感染的重新激活,包括类圆线虫。我们试图确定SARS-CoV-2-类圆线虫共感染的临床症状和人口统计学特征,特别是在患有严重疾病并接受免疫抑制药物治疗的患者中。要做到这一点,我们对文献进行了系统的回顾,并搜索了公共可访问的科学数据库——科学网,Scopus,PubMed/Medline和Embase-用于符合条件的研究(2019年12月1日至2022年8月30日)。审查方案在PROSPERO(CRD42022377062)中注册。描述性统计分析用于呈现共感染的临床和实验室参数;为此,我们使用以下公式计算患病率:阳性病例/总病例数×100。在总共593项研究中,17项研究报告26名共感染患者符合纳入本综述的标准。这些患者的中位年龄为55.14岁。大多数病例(53.8%)接受地塞米松治疗,其次是甲基强的松龙(26.9%)。26名患者中有18名是居住在欧洲国家或美国的移民;这些移民中的大多数来自拉丁美洲(58%)和东南亚(11%)。合并感染的最常见症状是腹痛(50%),发烧(46.1%),呼吸困难(30.7%)和咳嗽(30.7%),经常报告的实验室结果是嗜酸性粒细胞绝对计数高(38.4%),白细胞计数高(30.7%),高C反应蛋白(23.0%)和高中性粒细胞计数(19.2%)。26例患者中有2例(7.7%)具有致命结局。大多数SARS-CoV-2-类圆线虫共感染病例是生活在发达国家的移民,强调这些国家的临床医生需要了解与这种共感染相关的临床和实验室参数,以及快速准确的诊断测试对于及时有效的诊断和患者管理的关键重要性。