Transmission of CD has been greatly reduced where the parasitic disease is endemic; however, patients living with CD are getting older and require more medical attention. Age and comorbidities, such as cardiovascular disorders, are positively correlated; therefore, older individuals with CD are susceptible to severe SARS-CoV-2 infections. Additional research must be done to understand the role of comorbidities or immunosuppressive conditions in CD patients. 

Tulane University

Covid-19 has disproportionately affected countries that are at risk for endemic tropical diseases. Public health experts are concerned with the distribution of resources which has led to health disparities that have left patients with chronic diseases largely unprioritized. Chagas Disease (CD) is endemic to certain Latin American countries, which have large populations of patients with chronic CD. These patients are aging, at risk for chronic chagas cardiomyopathy, are burdened by severe comorbidities and are socioeconomically vulnerable. The extension of this pandemic within poorer, more disadvantaged regions has placed a considerable strain on the healthcare system and the available medical professionals. 

Epidemiological Considerations of the Global Pandemic

Zaidel, E. J., Forsyth, C. J., Novick, G., Marcus, R., Ribeiro, A., Pinazo, M. J., Morillo, C. A., Echeverría, L. E., Shikanai-Yasuda, M. A., Buekens, P., Perel, P., Meymandi, S. K., Ralston, K., Pinto, F., & Sosa-Estani, S. (2020). COVID-19: Implications for People with Chagas Disease. Global heart, 15(1), 69. https://doi.org/10.5334/gh.891

Covid-19: Implications for People with Chagas Disease

Patients with Chronic CD Are Ageing 

Chronic medical conditions may contribute to the progression of Chagas Disease or a more severe SARS-CoV-2 infection. Diabetes, COPD and cardiovascular diseases reduce the mortality of an individual with Covid-19. Elderly patients with chronic chagas cardiomyopathy (CCC) are more susceptible to respiratory diseases, such as Covid-19. Therefore, chronic Chagas Disease, CCC, age, pre-existing medical conditions and a poor socioeconomic position may increase the mortality rate of Covid-19 in affected populations. 

Patients with CD And Other Comorbidities 

Chagas Disease (CD), caused by the parasite Trypanosoma cruzi, has a vertical transmission average of 5% of pregnancies in women with chronic CD. Parasitic load largely determines the likelihood of congenital transmission occurring and the health implications for women with chronic CD and acute Covid-19 infections may be severe. The effects of SARS-CoV-2 on pregnant women with CD is relatively unknown and the lack of knowledge of the impact on parasitic loads is alarming. If SARS-CoV-2 infections increased parasitemia in pregnant women, the likelihood of maternal-fetal transmission would be very high. Consistent screening of infants with mothers exposed to Covid-19 and infected with T. cruzi allows epidemiologists to build an understanding of this concurrent infection. 

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