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Strongyloides and COVID-19: Challenges and Opportunities for Future Research

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dc.contributor.author Seeger, Daniel
dc.contributor.author Cornejo Cisneros, Enrique
dc.contributor.author Lucar, Jose
dc.contributor.author Denyer, Rachel
dc.date.accessioned 2023-03-23T15:49:32Z
dc.date.available 2023-03-23T15:49:32Z
dc.date.issued 2023
dc.identifier.uri https://hdl.handle.net/20.500.12866/13262
dc.description.abstract Strongyloides stercoralis is a soil transmitted helminth endemic to tropical and subtropical areas that can persist for decades in immunocompetent human hosts as a chronic asymptomatic infection. The use of corticosteroids, a mainstay of treatment for patients hospitalized with severe coronavirus disease (COVID-19), can trigger a life-threatening Strongyloides hyperinfection syndrome and disseminated disease. We identified 22 previously published cases of strongyloidiasis occurring in individuals with COVID-19, with one death reported among the seven patients who had Strongyloides hyperinfection syndrome. A total of seventeen patients had previously received corticosteroids, and of the five with no prior corticosteroid use, one presented with hyperinfection syndrome. We identify the key challenges in the diagnosis and treatment of Strongyloides within the context of COVID-19, including our imprecise knowledge of the global distribution of Strongyloides, the overlapping symptoms and signs of COVID-19 and Strongyloides hyperinfection syndrome, the limited utility of eosinophilia as a clinical marker for strongyloidiasis in this setting, the lack of validated algorithms to screen for Strongyloides prior to corticosteroid use, and the paucity of treatment options for critically ill patients with COVID-19 who cannot take oral ivermectin. Future research should focus on improved diagnostic methods and population prevalence estimates, optimizing the approaches for Strongyloides screening in persons with COVID-19 (including clinical trial participants and strategies for resource-limited settings) and better defining the role of pre-emptive treatment. en_US
dc.language.iso eng
dc.publisher MDPI
dc.relation.ispartofseries Tropical Medicine and Infectious Disease
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Strongyloides en_US
dc.subject COVID-19 en_US
dc.subject.mesh Strongyloides
dc.subject.mesh COVID-19
dc.title Strongyloides and COVID-19: Challenges and Opportunities for Future Research en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.3390/tropicalmed8020127
dc.relation.issn 2414-6366


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