Frontiers in Immunology (Aug 2022)

Recent malaria does not substantially impact COVID-19 antibody response or rates of symptomatic illness in communities with high malaria and COVID-19 transmission in Mali, West Africa

  • John Woodford,
  • Issaka Sagara,
  • Halimatou Diawara,
  • Mahamadoun Hamady Assadou,
  • Abdoulaye Katile,
  • Oumar Attaher,
  • Djibrilla Issiaka,
  • Gaoussou Santara,
  • Ibrahim H. Soumbounou,
  • Seydou Traore,
  • Moussa Traore,
  • Oumar M. Dicko,
  • Sidi Mohamed Niambele,
  • Almahamoudou Mahamar,
  • Bourama Kamate,
  • Bayaya Haidara,
  • Kourane Sissoko,
  • Seydou Sankare,
  • Sadio dite Koni Diarra,
  • Amatigue Zeguime,
  • Justin Y. A. Doritchamou,
  • Irfan Zaidi,
  • Alassane Dicko,
  • Patrick E. Duffy

DOI
https://doi.org/10.3389/fimmu.2022.959697
Journal volume & issue
Vol. 13

Abstract

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Malaria has been hypothesized as a factor that may have reduced the severity of the COVID-19 pandemic in sub-Saharan Africa. To evaluate the effect of recent malaria on COVID-19 we assessed a subgroup of individuals participating in a longitudinal cohort COVID-19 serosurvey that were also undergoing intensive malaria monitoring as part of antimalarial vaccine trials during the 2020 transmission season in Mali. These communities experienced a high incidence of primarily asymptomatic or mild COVID-19 during 2020 and 2021. In 1314 individuals, 711 were parasitemic during the 2020 malaria transmission season; 442 were symptomatic with clinical malaria and 269 had asymptomatic infection. Presence of parasitemia was not associated with new COVID-19 seroconversion (29.7% (211/711) vs. 30.0% (181/603), p=0.9038) or with rates of reported symptomatic seroconversion during the malaria transmission season. In the subsequent dry season, prior parasitemia was not associated with new COVID-19 seroconversion (30.2% (133/441) vs. 31.2% (108/346), p=0.7499), with symptomatic seroconversion, or with reversion from seropositive to seronegative (prior parasitemia: 36.2% (64/177) vs. no parasitemia: 30.1% (37/119), p=0.3842). After excluding participants with asymptomatic infection, clinical malaria was also not associated with COVID-19 serostatus or symptomatic seroconversion when compared to participants with no parasitemia during the monitoring period. In communities with intense seasonal malaria and a high incidence of asymptomatic or mild COVID-19, we did not demonstrate a relationship between recent malaria and subsequent response to COVID-19. Lifetime exposure, rather than recent infection, may be responsible for any effect of malaria on COVID-19 severity.

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