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. 2022 Aug 3:13:959697.
doi: 10.3389/fimmu.2022.959697. eCollection 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  1 , Issaka Sagara  2 , Halimatou Diawara  2 , Mahamadoun Hamady Assadou  2 , Abdoulaye Katile  2 , Oumar Attaher  2 , Djibrilla Issiaka  2 , Gaoussou Santara  2 , Ibrahim H Soumbounou  2 , Seydou Traore  2 , Moussa Traore  2 , Oumar M Dicko  2 , Sidi Mohamed Niambele  2 , Almahamoudou Mahamar  2 , Bourama Kamate  2 , Bayaya Haidara  2 , Kourane Sissoko  2 , Seydou Sankare  2 , Sadio Dite Koni Diarra  2 , Amatigue Zeguime  2 , Justin Y A Doritchamou  1 , Irfan Zaidi  1 , Alassane Dicko  2 , Patrick E Duffy  1
Affiliations

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 et al. Front Immunol. .

Abstract

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.

Keywords: COVID-19; West Africa; falciparum; malaria; serology; severity.

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Conflict of interest statement

The 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.

Figures

Figure 1
Figure 1
Study overview.
Figure 2
Figure 2
Effect of parasitemia and selected demographic covariates on new COVID-19 seroconversion during 2020 malaria transmission season (n=1314). Forest plot of odds ratios and 95% confidence intervals following logistic regression. Age group 18-49 years and Doneguebougou site were used as reference groups for nominal variables.
See this image and copyright information in PMC

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