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Abstract：
BACKGROUND: Toxoplasmosis is a serious or life-threatening disease in immunosuppressed patients and pregnant women. This study examined the likely association between Toxoplasma gondii infection and COVID-19 patients with moderate illness.
METHODS: Seventy blood samples were collected from patients at the Health Reference Laboratory of Tabriz, Northwest Iran from April 2021 to September 2021. In addition, 70 healthy subjects of the same age (37 ± 15 years) and sex distribution were ethnically matched. Sera samples were examined for the detection of anti-Toxoplasma antibodies using ELISA. Nested-PCR targets were amplified based on the B1 and GRA6 genes. GRA6 amplicons were subjected to sequencing and phylogenetic analysis.
RESULTS: The seroprevalence of toxoplasmosis based on IgG titer was 35.7% in the COVID‑19 patients and 27.1% in the control group, representing not to be associated with the Toxoplasma seropositivity in COVID‑19 patients (P = 0.18) compared to healthy subjects. Anti-T. gondii IgM was not found in any of the patients and healthy individuals. According to PCR amplification of the B1 and GRA6 genes, the frequency of T. gondii in COVID-19 patients was 14.2% (10/70). However, no T. gondii infection was detected in the healthy group. The CD4+T cell count was relatively lower in toxoplasmosis-infected patients (430-450 cells/mm3) than in control group (500-1500 cells/mm3). High genetic diversity (Hd: 0.710) of the type I strain of T. gondii was characterized in the patients. Present results showed that consumption of raw vegetables and close contact with stray cats can increase the transmission of T. gondii to COVID-19 patients (P < 0.01).
CONCLUSIONS: The current study revealed that T. gondii type I infection is unequivocally circulating among the COVID-19 patients in Tabriz; However, no significant association was observed between the occurrence of Toxoplasma and the severity of COVID-19. To make more accurate health decisions, multicenter investigations with a larger sample size of different ethnic groups of the Iranian population are needed.
METHODS: Seventy blood samples were collected from patients at the Health Reference Laboratory of Tabriz, Northwest Iran from April 2021 to September 2021. In addition, 70 healthy subjects of the same age (37 ± 15 years) and sex distribution were ethnically matched. Sera samples were examined for the detection of anti-Toxoplasma antibodies using ELISA. Nested-PCR targets were amplified based on the B1 and GRA6 genes. GRA6 amplicons were subjected to sequencing and phylogenetic analysis.
RESULTS: The seroprevalence of toxoplasmosis based on IgG titer was 35.7% in the COVID‑19 patients and 27.1% in the control group, representing not to be associated with the Toxoplasma seropositivity in COVID‑19 patients (P = 0.18) compared to healthy subjects. Anti-T. gondii IgM was not found in any of the patients and healthy individuals. According to PCR amplification of the B1 and GRA6 genes, the frequency of T. gondii in COVID-19 patients was 14.2% (10/70). However, no T. gondii infection was detected in the healthy group. The CD4+T cell count was relatively lower in toxoplasmosis-infected patients (430-450 cells/mm3) than in control group (500-1500 cells/mm3). High genetic diversity (Hd: 0.710) of the type I strain of T. gondii was characterized in the patients. Present results showed that consumption of raw vegetables and close contact with stray cats can increase the transmission of T. gondii to COVID-19 patients (P < 0.01).
CONCLUSIONS: The current study revealed that T. gondii type I infection is unequivocally circulating among the COVID-19 patients in Tabriz; However, no significant association was observed between the occurrence of Toxoplasma and the severity of COVID-19. To make more accurate health decisions, multicenter investigations with a larger sample size of different ethnic groups of the Iranian population are needed.
摘要：
背景：弓形虫病是免疫抑制患者和孕妇的严重或危及生命的疾病。这项研究调查了弓形虫感染与COVID-19中度疾病患者之间的可能关联。
方法：在大不里士健康参考实验室从患者身上采集了70份血液样本，伊朗西北部，2021年4月至2021年9月。此外,70例年龄（37±15岁）和性别分布相同的健康受试者进行种族匹配。使用ELISA检查血清样品以检测抗弓形虫抗体。基于B1和GRA6基因扩增巢式PCR靶标。对GRA6扩增子进行测序和系统发育分析。
结果：基于IgG滴度的弓形虫病血清阳性率在COVID-19患者中为35.7％，在对照组中为27.1％，与健康受试者相比，COVID‑19患者的弓形虫血清阳性与弓形虫血清阳性无关(P=0.18)。反T.在任何患者和健康个体中均未发现刚地IgM。根据B1和GRA6基因的PCR扩增，COVID-19患者中弓形虫的频率为14.2%(10/70)。然而,健康组未检测到弓形虫感染。弓形虫感染患者（430-450细胞/mm3）的CD4T细胞计数相对低于对照组（500-1500细胞/mm3）。患者中具有I型弓形虫菌株的高遗传多样性（Hd：0.710）。结果表明，食用生蔬菜和与流浪猫密切接触可增加弓形虫在COVID-19患者中的传播（P<0.01）。
结论：目前的研究表明，I型弓形虫感染在大不里士的COVID-19患者中明显流行；然而，弓形虫的发生与COVID-19的严重程度之间没有显着关联。为了做出更准确的健康决定，需要对伊朗人口的不同种族群体进行更大的样本量的多中心调查。
方法：在大不里士健康参考实验室从患者身上采集了70份血液样本，伊朗西北部，2021年4月至2021年9月。此外,70例年龄（37±15岁）和性别分布相同的健康受试者进行种族匹配。使用ELISA检查血清样品以检测抗弓形虫抗体。基于B1和GRA6基因扩增巢式PCR靶标。对GRA6扩增子进行测序和系统发育分析。
结果：基于IgG滴度的弓形虫病血清阳性率在COVID-19患者中为35.7％，在对照组中为27.1％，与健康受试者相比，COVID‑19患者的弓形虫血清阳性与弓形虫血清阳性无关(P=0.18)。反T.在任何患者和健康个体中均未发现刚地IgM。根据B1和GRA6基因的PCR扩增，COVID-19患者中弓形虫的频率为14.2%(10/70)。然而,健康组未检测到弓形虫感染。弓形虫感染患者（430-450细胞/mm3）的CD4T细胞计数相对低于对照组（500-1500细胞/mm3）。患者中具有I型弓形虫菌株的高遗传多样性（Hd：0.710）。结果表明，食用生蔬菜和与流浪猫密切接触可增加弓形虫在COVID-19患者中的传播（P<0.01）。
结论：目前的研究表明，I型弓形虫感染在大不里士的COVID-19患者中明显流行；然而，弓形虫的发生与COVID-19的严重程度之间没有显着关联。为了做出更准确的健康决定，需要对伊朗人口的不同种族群体进行更大的样本量的多中心调查。
