Background Despite reports of malaria and coronavirus diseases 2019 (COVID-19) co-infection, malaria-endemic regions have so far recorded fewer cases of COVID-19 and deaths from COVID-19, indicating a probable protection from the poor outcome of COVID-19 by malaria. On the contrary, other evidence suggests that malaria might contribute to the death caused by COVID-19. Hence, this paper reviewed existing evidence hypothesizing poor outcome or protection of COVID-19 patients when co-infected with malaria. Methods PRISMA guidelines for systematic review were employed in this study. Published articles from December 2019 to May 2021on COVID-19 and malaria co-infection and outcome were systematically searched in relevant and accessible databases following a pre-defined strategy. Studies involving human, in vivo animal studies, and in vitro studies were included. Results Twenty three (23) studies were included in the review out of the 3866 records identified in the selected scientific databases. Nine (9) papers reported on co-infection of COVID-19 and malaria. Five (5) papers provided information about synergism of malaria and COVID-19 poor prognosis, 2 papers reported on syndemic of COVID-19 and malaria intervention, and 7 studies indicated that malaria protects individuals from COVID-19. Conclusions Low incidence of COVID-19 in malaria-endemic regions supports the hypothesis that COVID-19 poor prognosis is prevented by malaria. Although further studies are required to ascertain this hypothesis, cross-immunity and common immunodominant isotopes provide strong evidence to support this hypothesis. Also, increase in co-inhibitory receptors and atypical memory B cells indicate synergy between COVID-19 and malaria outcome, though, more studies are required to make a definite conclusion. Highlights Low incidence and mortality rate of COVID-19 in malaria endemic regions There have been reports of malaria and COVID-19 co-infection Malaria could be the link for the reported low incidence of COVID-19 in Africa Cross immunity and common immunodominant epitopes between Malaria and COVID-19, and antimalaria drugs could be the reason for observed low fatality and incidence rate of COVID-19 in malaria endemic regions. Malaria infection and deaths could increase amid the COVID-19 pandemic due to interrupted malaria control interventions.
【저자키워드】 COVID-19, SARS-CoV-2, malaria, Plasmodium falciparum, Malaria-COVID 19 co-infection, 【초록키워드】 coronavirus disease, COVID-19 pandemic, Infection, systematic review, Intervention, outcome, database, Region, Co-infection, death, incidence rate, receptor, mortality rate, incidence, in vivo, information, synergy, memory B cell, fatality, Evidence, Endemic, Hypothesis, Atypical, COVID-19 patient, malaria control, Support, individual, poor prognosis, contrary, in vitro study, article, immunodominant, synergism, regions, immunodominant epitope, PROTECT, Result, selected, caused, reported, indicated, required, provided, searched, contribute, increase in, prevented, recorded, antimalaria drug, Cross immunity, incidence of COVID-19, 【제목키워드】 Mortality, severity, Co-infection, incidence of COVID-19,