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Review
. 2021 Feb 18:12:565625.
doi: 10.3389/fimmu.2021.565625. eCollection 2021.

Less Severe Cases of COVID-19 in Sub-Saharan Africa: Could Co-infection or a Recent History of Plasmodium falciparum Infection Be Protective?

Allan Kalungi  1   2   3 , Eugene Kinyanda  1   2 , Dickens Howard Akena  2 , Pontiano Kaleebu  4 , Innocent M Bisangwa  5
Affiliations
Review

Less Severe Cases of COVID-19 in Sub-Saharan Africa: Could Co-infection or a Recent History of Plasmodium falciparum Infection Be Protective?

Allan Kalungi et al. Front Immunol. .

Abstract

Sub-Saharan Africa has generally experienced few cases and deaths of coronavirus disease 2019 (COVID-19). In addition to other potential explanations for the few cases and deaths of COVID-19 such as the population socio-demographics, early lockdown measures and the possibility of under reporting, we hypothesize in this mini review that individuals with a recent history of malaria infection may be protected against infection or severe form of COVID-19. Given that both the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and Plasmodium falciparum (P. falciparum) merozoites bind to the cluster of differentiation 147 (CD147) immunoglobulin, we hypothesize that the immunological memory against P. falciparum merozoites primes SARS-CoV-2 infected cells for early phagocytosis, hence protecting individuals with a recent P. falciparum infection against COVID-19 infection or severity. This mini review therefore discusses the potential biological link between P. falciparum infection and COVID-19 infection or severity and further highlights the importance of CD147 immunoglobulin as an entry point for both SARS-CoV-2 and P. falciparum into host cells.

Keywords: COVID-19; Plasmodium falciparum infection; SARS–CoV-2; Sub-Saharan Africa; co-infection.

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Conflict of interest statement

IMB is a director at ATCG Solutions (Uganda) Limited, a molecular diagnostics laboratory that had no commercial interest in the present study. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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