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. 2023 Oct 17;13(1):17636.
doi: 10.1038/s41598-023-44616-3.

Association between breakthrough infection with COVID-19 and Toxoplasma gondii: a cross-sectional study

Marwa A Gouda  1 , Hind S AboShabaan  2 , Ahmed S Abdelgawad  2 , Aliaa Sabry Abdel Wahed  3 , Khaled A Abd El-Razik  4 , Yara Elsaadawy  5 , Ayman A Abdel-Wahab  6 , Yousry Hawash  6
Affiliations

Association between breakthrough infection with COVID-19 and Toxoplasma gondii: a cross-sectional study

Marwa A Gouda et al. Sci Rep. .

Abstract

The breakthrough infection following COVID-19 vaccination has been a subject of concern recently. Evidence suggests that COVID-19 vaccine efficacy diminishes over time due to multiple factors related to the host, and vaccine. Coinfection with other pathogens was claimed earlier as a contributing cause for this phenomenon. Hence, we aimed to stratify the association of post-COVID-19 vaccination breakthrough coinfection with Toxoplasma gondii (T. gondii) and its impact on disease severity. This cross-sectional study included 330 COVID-19-vaccinated patients confirmed by RT-PCR. They were also screened for anti- T. gondii antibodies using ELISA. Toxoplasma seropositive cases' whole blood was screened for DNA using PCR to correlate results with COVID-19 severity. Out of 330 COVID-19 vaccinated patients with breakthrough infection, 34.5% (114 patients) showed positivity for Toxoplasma IgG by ELISA, and none of the cases was IgM positive. Eleven patients (9.6%) of the IgG-positive cases were positive by PCR. Positive PCR cases correlated positively with the Toxoplasma IgG titer (P < 0.001), and the Cutoff point was 191.5. Molecular analysis of Toxoplasma and COVID-19 severity showed that 8 (72.7%), 1 (9.1%), and 2 cases (18.2%) had mild, moderate, and severe courses of the disease, respectively, with no significant correlation. Our study reported a heightened prevalence of latent toxoplasmosis among mild cases of COVID-19 breakthrough infection. Nevertheless, a discernible correlation between latent toxoplasmosis and COVID-19 severity is lacking. Hence, implementing studies on a larger scale could provide a more comprehensive comprehension of this association.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Agarose gel electrophoresis of PCR results. Agarose gel electrophoresis showing T. gondii DNA detection results by conventional PCR. From left to right the first two lanes correspond to positive control samples of Rh and ME49 strains respectively; Lanes 3–13 represent positive samples at 96 bp. M refers to Molecular band size. The image was taken using the gel documentation system directly.
Figure 2
Figure 2
Flowchart of the participants in the study.
Figure 3
Figure 3
PCR findings in relation to the concentration of Toxoplasma IgG antibodies.
Figure 4
Figure 4
ROC Curve analysis for Toxoplasma IgG titer in predicting PCR positivity.
See this image and copyright information in PMC

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Publication types

Supplementary concepts