Skip to main content
Download PDF

Plasmodium vivax and SARS-CoV-2 co-infection in Venezuelan pregnant women: a case series

Malaria Journal volume 22, Article number: 11 (2023) Cite this article

Abstract

Background

Malaria‐endemic areas are not spared from the impact of coronavirus disease 2019 (COVID-19), leading to co-infection scenarios where overlapping symptoms impose serious diagnostic challenges. Current knowledge on Plasmodium spp. and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) co‐infection in pregnant women remains limited, especially in Latin America, where Plasmodium vivax infection is highly prevalent.

Methods

This is a case series of five pregnant women with P. vivax and SARS-CoV-2 co-infection hospitalized in two main malaria referral centers of the Capital District and Bolivar state, Venezuela between March 13, 2020 and December 31, 2021.

Results

Clinical and laboratory data from five pregnant women with a mean age of 22 years were analyzed; three of them were in the third trimester of pregnancy. Comorbidities included obesity in two cases, hypertension in one, and asthma in one. Three out of five patients had severe to critical COVID-19 disease. Dry cough, fever, chills, and headache were the most frequent symptoms reported. Laboratory analyses showed elevated aspartate/alanine aminotransferase and creatinine levels, thrombocytopenia, and severe anemia as the most relevant abnormalities. The mean period between symptom onset and a positive molecular test for SARS-CoV-2 infection or positive microscopy for Plasmodium spp. was 4.8 ± 2.5 days and 2.8 ± 1.6 days, respectively. The mean hospital stay was 5.4 ± 7 days. Three women recovered and were discharged from the hospital. Two women died, one from cerebral malaria and one from respiratory failure. Three adverse fetal outcomes were registered, two miscarriages and one stillbirth.

Conclusion

This study documented a predominance of severe/critical COVID-19 disease and a high proportion of adverse maternal–fetal outcomes among pregnant women with malaria and COVID-19 co-infection. More comprehensive prospective cohort studies are warranted to explore the risk factors, management challenges, and clinical outcomes of pregnant women with this co-infection.

Background

The impact of coronavirus disease 2019 (COVID-19) in the world has been unprecedented, particularly affecting low- and middle-income countries where healthcare systems are already weakened and overburden by other diseases such as malaria and arboviral diseases [1, 2]. Pregnant women who live in malaria-endemic areas and get infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may be at increased risk of severe COVID-19 or unfavorable disease outcomes if their malaria status is overlooked [3].

Most malaria and COVID-19 co-infections had been reported in Africa and Asia, where patients with Plasmodium falciparum and SARS-CoV-2 co-infection were typically oligosymptomatic at presentation with mild to moderate parasitemia, thrombocytopenia, lymphopenia, and elevated bilirubin levels [3, 4]. However, a recent study has shown that co-infection may be associated with higher in-hospital mortality compared to SARS-CoV-2 mono-infection [5]. Current knowledge on malaria and COVID-19 co-infection in pregnant women remains limited [6, 7], especially in Latin America, where Plasmodium vivax infection is highly prevalent.

Venezuela remains a malaria breeding ground in the region, representing 34% of cases and 47% of disease-related deaths in America in 2021. Of note, P. vivax accounted for 82% of reported cases, followed by P. falciparum (13%), and mixed malaria (P. vivax/P. falciparum; 4%) [8]. This is a case series of pregnant women with P. vivax and SARS-CoV-2 co-infection in Venezuela.

Methods

A retrospective medical record review of all malaria and COVID-19 co-infections in pregnant women registered at the Centro para Estudios sobre Malaria, Capital District and “Ruiz y Páez” University Hospital Complex, Bolivar state, Venezuela (March 13, 2020 to December 31, 2021) was conducted. Clinical and laboratory data were obtained from the patients’ medical records. Laboratory tests were carried on the hospital as part of the routine management. Malaria diagnosis by microscopy was performed using Giemsa-stained blood smears, but data on parasite density were not available. SARS-CoV-2 infection was confirmed by reverse transcription polymerase chain reaction (RT-PCR) [9] at the “Rafael Rangel” National Institute of Hygiene (Venezuela).

The severity of COVID-19 was characterized as mild (defined as any of the various signs and symptoms of COVID-19 but no shortness of breath, dyspnea, or abnormal chest imaging), moderate (defined as evidence of lower respiratory disease during clinical assessment or imaging and an oxygen saturation ≥ 94% on room air at sea level), severe (defined as oxygen saturation < 94% on room air at sea level, a ratio of arterial partial pressure of oxygen to fraction of inspired oxygen < 300 mmHg, a respiratory rate > 30 breaths/min, or lung infiltrates > 50%), or critical (defined as respiratory failure, septic shock, and/or multiple organ dysfunction), according to the National Institutes of Health (United States) guidelines [10].

Results

A total of 253 and 2547 medical records of malaria cases at the Centro para Estudios sobre Malaria and “Ruiz y Páez” University Hospital Complex, respectively, were reviewed. The demographic, clinical, and paraclinical profiles of five pregnant women with confirmed co-infection by P. vivax and SARS-CoV-2 were recorded (Tables 1, 2). All pregnant woman were managed as inpatients regardless of their clinical condition, two of them had critical COVID-19 disease, while one of each had mild, moderate, or severe COVID-19 disease. None of them received remdesivir or tocilizumab for the management of COVID-19. Per protocol, all patients with severe/critical COVID-19 disease received steroids, supplemental oxygen, and thrombosis prophylaxis. All pregnant women also received anti-malarial treatment according to the latest national protocol [11]. The mean period between symptom onset and a positive test was 4.8 ± 2.5 days for SARS-CoV-2 infection and 2.8 ± 1.6 for Plasmodium spp. The mean time lag between the two diagnoses was 3.8 ± 1.3 days. Although malaria confirmation preceded the diagnosis of COVID-19 by three to five days, none of COVID-19 cases were considered hospital-acquired.

Table 1 Demographic and clinical profiles of pregnant women co-infected with P. vivax and SARS-CoV-2
Full size table
Table 2 Paraclinical profile of pregnant women co-infected with P. vivax and SARS-CoV-2
Full size table

Patients’ age ranged from 15 to 28 years (mean 22 ± 5 years). Three of them were in the third trimester of pregnancy, two suffered from obesity, one was hypertense, and one was asthmatic. Dry cough (4/5), fever (3/5), chills (3/5), and headache (2/5) were the most frequent symptoms reported on admission. Less common symptoms included dyspnea (1/5), arthralgia (1/5), and vomiting (1/5). Mild elevations of hepatic enzymes, creatinine, and urea serum levels were observed. Likewise, patients exhibited mild alterations in the number of platelets, leucocytes, and neutrophils. Only one had severe anemia and none of them had lymphopenia. Three pregnant women recovered and were discharged from the hospital. Two women died, one from cerebral malaria and one from respiratory failure. Three adverse fetal outcomes were registered, two miscarriages and one stillbirth. The mean hospital stay was 5.4 ± 7 days.

Discussion

This analysis describes a case series of five pregnant women with malaria and COVID-19 co-infection in Venezuela, with a predominance of severe/critical COVID-19, including two maternal–fetal deaths and one stillbirth. Although some reports showed that P. vivax and SARS-CoV-2 co-infection had a mainly mild clinical course [12,13,14], even in pregnant women [7, 15], a high proportion of moderate/severe COVID-19 disease among co-infected patients in Venezuela was recently reported [16].

Malaria and COVID-19 symptoms may overlap and delay the diagnosis of co-infection. Symptoms on admission in this case series were similar to those previously reported [3, 15], being anemia and thrombocytopenia two common laboratory alterations among pregnant women with this co-infection [3]. It is unclear whether laboratory parameters could help discriminate malaria and COVID-19 co-infection [3], since some laboratory alterations may be more common in SARS-CoV-2 mono-infected than in co-infected patients and yet other more frequent in malaria mono-infected patients [17,18,19,20].

Since malaria and COVID-19 have different incubation periods, one infection could potentiate the subsequent one. To the authors’ knowledge, this has not been addressed or reviewed at full length in other studies. Indeed, only few studies have examined this potential relationship [21]. A unifying theme of the pathogenesis of both diseases is oxidative stress via 8-iso-prostaglandin F2α (8-iso-PGF2α). Muhammad et al. [22], for example, reported in 2020 that 8-iso-PGF2α levels were significantly higher in patients co-infected with malaria and COVID-19 as those only infected with COVID-19; further, the levels of 8-iso-PGF2α were proportional to malaria parasite density in the infected patients. Therefore, albeit more studies are warranted, a tentative potentiation effect could be inferred in this rare co-infection setting. Osei et al. [21] have postulated that T-cell exhaustion or inadequate B-cell response could be the culprit.

A higher risk of adverse outcomes in pregnant women with either Plasmodium spp. [23] or SARS-CoV-2 [24, 25] have been reported, but not so much for co-infected pregnant women, including co-infection with P. vivax [7, 15] and Plasmodium ovale [6]. No similar reports for P. falciparum co-infection were found. Pregnancy-associated malaria increases the risk of anemia, stillbirth, low birth weight, and maternal–fetal death due to systemic and placental inflammatory responses and microvascular dysfunction [23, 26]. SARS-CoV-2 mono-infection during pregnancy is also associated with an increased risk of pre-eclampsia, preterm birth, low birth weight, stillbirth, and mechanical ventilation [27, 28]. Severe placentitis and vascular dysfunction have been described, leading to long-term multisystemic defects in exposed infants [24]. Thus, delayed care may have life-threatening consequences [15], as was evident in three of the five patients of this case series.

Recently, it was documented a high prevalence of maternal–fetal complications in Venezuela caused mainly by P. vivax [29], traditionally described as benign. On the other hand, while the clinical behavior of patients with COVID-19 during the first wave in Venezuela showed a high overall and in-hospital mortality [30], the clinical outcome of the first locally recorded pregnant woman infected with SARS-CoV-2 and her child was favorable [31]. However, two recent studies reported a high prevalence of maternal–fetal events among Venezuelan pregnant women with COVID-19 [32, 33]. Therefore, simultaneous infection with these two pathogens could create a favorable setting leading to increased maternal–fetal risk in pregnant women.

Due to the retrospective nature of this work, several limitations were unavoidable. Clinical and paraclinical information was incomplete for some patients and we did not collect specific outcomes of COVID-19-associated post-acute complications, such as thrombotic events. Moreover, there was an inherent selection bias, as all analyzed cases came from the primary malaria-endemic region of the country and included only hospitalized cases, so these severe maternal–fetal results cannot be extrapolated to populations with different epidemiological and clinical characteristics. As a strength, all malaria and COVID-19 co-infections in the current case series were confirmed by microscopy and RT-PCR, respectively. In the case of the dead pregnant woman with cerebral malaria, although no co-infection by P. falciparum was detected in the Giemsa-stained peripheral blood smears, such possibility cannot be ruled out, since blood samples not taken during the febrile peak may not reveal low level circulating parasites, as most of them remain adhered to vascular endothelia. Because a high level of false-positive results with the SARS-CoV-2 serological assay has been identified in highly malaria-endemic areas [34, 35], routine use of serological assay may overestimate the level of exposure and immunity of the population to SARS-CoV-2 in malaria-endemic countries [36].

Conclusions

This study documented a predominance of severe/critical COVID-19 diseases, as well as a high proportion of adverse maternal–fetal outcomes among malaria co-infected pregnant women. COVID-19 has become an unprecedented challenge to healthcare systems worldwide and has affected malaria control programs by delaying the distribution of insecticide-treated nets, and disrupting early diagnosis and drug supplies, among others [37, 38]. Malaria-endemic areas in Venezuela are not spared from those challenges [39] and delays in malaria diagnosis during pregnancy could favor mortality and severe complications [40]. Thus, the need for timely diagnosis to ensure an appropriate clinical management is emphasized. Furthermore, large prospective cohort studies are warranted to explore the risk factors, clinical outcomes, management challenges, and outcome of pregnant women with this co-infection.

Availability of data and materials

All data and materials in this article are included in the manuscript.

Abbreviations

COVID-19:

Coronavirus disease 2019

SARS-CoV-2:

Severe acute respiratory syndrome coronavirus 2

RT-PCR:

Reverse transcription polymerase chain reaction

8-iso-PGF2α:

8-iso-prostaglandin F2α

References

  1. Bong CL, Brasher C, Chikumba E, McDougall R, Mellin-Olsen J, Enright A. The COVID-19 pandemic: effects on low- and middle-income countries. Anesth Analg. 2020;131:86–92.

    Article  CAS  Google Scholar 

  2. Litewka SG, Heitman E. Latin American healthcare systems in times of pandemic. Dev World Bioeth. 2020;20:69–73.

    Article  Google Scholar 

  3. Wilairatana P, Masangkay FR, Kotepui KU, Milanez GJ, Kotepui M. Prevalence and characteristics of malaria among COVID-19 individuals: a systematic review, meta-analysis, and analysis of case reports. PLoS Negl Trop Dis. 2021;15: e0009766.

    Article  CAS  Google Scholar 

  4. Nachega JB, Sam-Agudu NA, Machekano RN, Rosenthal PJ, Schell S, de Waard L, et al. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection and pregnancy in sub-Saharan Africa: a 6-country retrospective cohort analysis. Clin Infect Dis. 2022;75:1950–61.

    Article  Google Scholar 

  5. Hussein R, Guedes M, Ibraheim N, Ali MM, El-Tahir A, Allam N, et al. Impact of COVID-19 and malaria coinfection on clinical outcomes: a retrospective cohort study. Clin Microbiol Infect. 2022;28:1152.e1-e6.

    Article  CAS  Google Scholar 

  6. Papaccio M, Castellani R, Zanardini C, Sartori E, Prefumo F, Saccani B. Pregnancy and COVID-19: do not overlook malaria. Int J Gynaecol Obstet. 2021;153:550–1.

    Article  CAS  Google Scholar 

  7. Minkobame U, Mveang Nzoghe A, Maloupazoa Siawaya AC, Alame-Emane AK, Ndong Sima CAA, Mvoundza Ndjindji O, et al. Case series of SARS-COV-2 infection in pregnant African women: focus on biological features. J Med Virol. 2021;93:4147–51.

    Article  CAS  Google Scholar 

  8. WHO. World malaria report 2022. Geneva, World Health Organization. 2022.

  9. WHO. Protocol: real-time RT-PCR assays for the detection of SARS-CoV-2. Geneva, World Health Organization. 2020. https://www.who.int/docs/default-source/coronaviruse/real-time-rt-pcr-assays-for-the-detection-of-sars-cov-2-institut-pasteur-paris pdf 2020.

  10. Coronavirus Disease. Treatment Guidelines Bethesda. DC: National Institutes of Health; 2019.

    Google Scholar 

  11. PAHO. Pautas de tratamiento en casos de malaria: República Bolivariana de Venezuela, Ministerio del Poder Popular para la Salud 2017. DC: Pan American Health Organization; 2017.

    Google Scholar 

  12. Mahajan NN, Gajbhiye RK, Bahirat S, Lokhande PD, Mathe A, Rathi S, et al. Co-infection of malaria and early clearance of SARS-CoV-2 in healthcare workers. J Med Virol. 2021;93:2431–8.

    Article  CAS  Google Scholar 

  13. Boonyarangka P, Phontham K, Sriwichai S, Poramathikul K, Harncharoenkul K, Kuntawunginn W, et al. Co-infection with Plasmodium vivax and COVID-19 in Thailand. Trop Med Infect Dis. 2022;7:145.

    Article  Google Scholar 

  14. Sardar S, Sharma R, Alyamani TYM, Aboukamar M. COVID-19 and Plasmodium vivax malaria co-infection. IDCases. 2020;21: e00879.

    Article  Google Scholar 

  15. Mahajan NN, Kesarwani SN, Shinde SS, Nayak A, Modi DN, Mahale SD, et al. Co-infection of malaria and dengue in pregnant women with SARS-CoV-2. Int J Gynaecol Obstet. 2020;51:459–62.

    Article  Google Scholar 

  16. Forero-Peña DA, Carrión-Nessi FS, Omaña-Ávila ÓD, Mendoza-Millán DL, Romero SR, Escalante-Pérez IA, et al. Plasmodium vivax and SARS-CoV-2 co-infection in venezuela: a case series from the malaria hotspot in Latin America. Travel Med Infect Dis. 2022;50: 102460.

    Article  Google Scholar 

  17. Kotepui M, Kotepui KU, Milanez GD, Masangkay FR. Reduction in total leukocytes in malaria patients compared to febrile controls: a systematic review and meta-analysis. PLoS ONE. 2020;15: e0233913.

    Article  CAS  Google Scholar 

  18. Woodford J, Shanks GD, Griffin P, Chalon S, McCarthy JS. The dynamics of liver function test abnormalities after malaria infection: a retrospective observational study. Am J Trop Med Hyg. 2018;98:1113–9.

    Article  CAS  Google Scholar 

  19. Meltzer E, Keller S, Shmuel S, Schwartz E. D-dimer levels in non-immune travelers with malaria. Travel Med Infect Dis. 2019;27:104–6.

    Article  Google Scholar 

  20. Barffour MA, Schulze KJ, Coles CL, Chileshe J, Kalungwana N, Siamusantu W, et al. Malaria exacerbates inflammation-associated elevation in ferritin and soluble transferrin receptor with only modest effects on iron deficiency and iron deficiency anaemia among rural Zambian children. Trop Med Int Health. 2018;23:53–62.

    Article  CAS  Google Scholar 

  21. Osei SA, Biney RP, Anning AS, Nortey LN, Ghartey-Kwansah G. Low incidence of COVID-19 case severity and mortality in Africa: could malaria co-infection provide the missing link? BMC Infect Dis. 2022;22:78.

    Article  CAS  Google Scholar 

  22. Muhammad Y, Aminu YK, Ahmad AE, Iliya S, Muhd N, Yahaya M, et al. An elevated 8-isoprostaglandin F2 alpha (8-iso-PGF2α) in COVID-19 subjects co-infected with malaria. Pan Afr Med J. 2020;37:78.

    Article  Google Scholar 

  23. Bauserman M, Conroy AL, North K, Patterson J, Bose C, Meshnick S. An overview of malaria in pregnancy. Semin Perinatol. 2019;43:282–90.

    Article  Google Scholar 

  24. Kumar D, Verma S, Mysorekar IU. COVID-19 and pregnancy: clinical outcomes; mechanisms, and vaccine efficacy. Transl Res. 2022;251:84–95.

    Article  Google Scholar 

  25. Tanna R, Dugarte HJN, Kurakula S, Muralidharan V, Das A, Kanigalpula SPR, et al. Review of impact of COVID-19 on maternal, neonatal outcomes, and placental changes. Cureus. 2022;14: e28631.

    Google Scholar 

  26. Dayananda KK, Achur RN, Gowda DC. Epidemiology, drug resistance, and pathophysiology of Plasmodium vivax malaria. J Vector Borne Dis. 2018;55:1–8.

    Article  Google Scholar 

  27. Nachega JB, Sam-Agudu NA, Budhram S, Taha TE, Vannevel V, Somapillay P, et al. Effect of SARS-CoV-2 infection in pregnancy on maternal and neonatal outcomes in Africa: an AFREhealth call for evidence through multicountry research collaboration. Am J Trop Med Hyg. 2020;104:461–5.

    Google Scholar 

  28. Jamieson DJ, Rasmussen SA. An update on COVID-19 and pregnancy. Am J Obstet Gynecol. 2022;226:177–86.

    Article  CAS  Google Scholar 

  29. Romero M, Leiba E, Carrión-Nessi FS, Freitas-De Nobrega DC, Kaid-Bay S, Gamardo ÁF, et al. Malaria in pregnancy complications in southern Venezuela. Malar J. 2021;20:186.

    Article  Google Scholar 

  30. Forero-Peña DA, Carrión-Nessi FS, Mendoza-Millán DL, Omaña-Ávila ÓD, Mejía-Bernard MD, Camejo-Ávila NA, et al. First wave of COVID-19 in Venezuela: epidemiological, clinical, and paraclinical characteristics of first cases. J Med Virol. 2022;94:1175–85.

    Article  Google Scholar 

  31. Forero-Peña DA, Rodríguez MI, Flora-Noda DM, Maricuto AL, Velásquez VL, Soto LM, et al. The first pregnant woman with COVID-19 in Venezuela: pre-symptomatic transmission. Travel Med Infect Dis. 2020;36: 101805.

    Article  Google Scholar 

  32. Áñez MPC, Carrero OMM, Narváez T, Blanco MG. COVID-19 durante la gestación: resultados maternos y perinatales. Rev Obstet Ginecol Venez. 2022;82:5–20.

    Article  Google Scholar 

  33. Carrión-Nessi FS, Castro MP, Freitas-De Nobrega DC, Moncada-Ortega A, Omaña-Ávila ÓD, Mendoza-Millán DL, et al. Clinical-epidemiological characteristics and maternal-foetal outcomes in pregnant women hospitalised with COVID-19 in Venezuela: a retrospective study. BMC Pregnancy Childbirth. 2022;2:905.

    Article  Google Scholar 

  34. Steinhardt LC, Ige F, Iriemenam NC, Greby SM, Hamada Y, Uwandu M, et al. Cross-reactivity of two SARS-CoV-2 serological assays in a setting where malaria is endemic. J Clin Microbiol. 2021;59: e0051421.

    Article  Google Scholar 

  35. Vanroye F, Bossche DVD, Brosius I, Tack B, Esbroeck MV, Jacobs J. COVID-19 antibody detecting rapid diagnostic tests show high cross-reactivity when challenged with pre-pandemic malaria, schistosomiasis and dengue samples. Diagnostics. 2021;11:1163.

    Article  CAS  Google Scholar 

  36. Lapidus S, Liu F, Casanovas-Massana A, Dai Y, Huck JD, Lucas C, et al. Plasmodium infection induces cross-reactive antibodies to carbohydrate epitopes on the SARS-CoV-2 Spike protein. medRxiv. 2021. https://doi.org/10.1038/s41598-022-26709-7.

    Article  Google Scholar 

  37. Rogerson SJ, Beeson JG, Laman M, Poespoprodjo JR, William T, Simpson JA, et al. Identifying and combating the impacts of COVID-19 on malaria. BMC Med. 2020;18:239.

    Article  CAS  Google Scholar 

  38. WHO. Community-based health care, including outreach and campaigns, in the context of the COVID-19 pandemic: interim guidance May 2020. Geneva. World Health Organization. 2020.

  39. Lampo M, Hernández-Villena JV, Cascante J, Vincenti-González MF, Forero-Peña DA, Segovia MJ, et al. Signatures of the Venezuelan humanitarian crisis in the first wave of COVID-19: fuel shortages and border migration. Vaccines. 2021;9:719.

    Article  CAS  Google Scholar 

  40. Hussein MIH, Albashir AAD, Elawad O, Homeida A. Malaria and COVID-19: unmasking their ties. Malar J. 2020;19:457.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We thank all staff of the Centro para Estudios sobre Malaria and “Ruiz y Páez” University Hospital Complex and research staff involved in the work.

Funding

The authors received no specific funding for this work.

Author information

Authors and Affiliations

  1. Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolivar, Venezuela

    Fhabián S. Carrión-Nessi, Daniela L. Mendoza-Millán, Óscar D. Omaña-Ávila, Sinibaldo R. Romero, Augusto Moncada-Ortega & David A. Forero-Peña

  2. “Dr. Francisco Battistini Casalta” Health Sciences School, University of Oriente – Bolivar Nucleus, Ciudad Bolivar, Venezuela

    Fhabián S. Carrión-Nessi

  3. “Luis Razetti” School of Medicine, Central University of Venezuela, Caracas, Venezuela

    Daniela L. Mendoza-Millán & Óscar D. Omaña-Ávila

  4. Medical Scientist Training Program (MD/PhD), University of Minnesota Medical School, Minneapolis, USA

    Sinibaldo R. Romero

  5. “José María Vargas” School of Medicine, Central University of Venezuela, Caracas, Venezuela

    Augusto Moncada-Ortega

  6. Centre for Medical Parasitology, Department of Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

    Mary Lopez-Perez

  7. Infectious Diseases Section, “Dr. Félix Pifano” Tropical Medicine Institute, Central University of Venezuela, Caracas, Venezuela

    Jaime R. Torres & Óscar Noya-González

  8. Centro Para Estudios Sobre Malaria, “Dr. Arnoldo Gabaldón” High Studies Institute, Caracas, Venezuela

    Óscar Noya-González

  9. Infectious Diseases Department, University Hospital of Caracas, Caracas, Venezuela

    David A. Forero-Peña

Authors
  1. Fhabián S. Carrión-Nessi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Daniela L. Mendoza-Millán
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Óscar D. Omaña-Ávila
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sinibaldo R. Romero
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Augusto Moncada-Ortega
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Mary Lopez-Perez
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Jaime R. Torres
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Óscar Noya-González
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. David A. Forero-Peña
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

FSCN and DAFP carried out the literature search and drafted the first version of the manuscript. FSCN, DLMM, ÓDOÁ, SRR, AMO, MLP, and DAFP were responsible for designing. FSCN, MLP, JRT, and ÓNG supervised the completion of this case series and substantively revised it. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Fhabián S. Carrión-Nessi or David A. Forero-Peña.

Ethics declarations

Ethics approval and consent to participate

Not applicable.

Consent for publication

All patients included in this study signed a consent form authorizing the use of their medical records for the purpose of this publication. A copy of each patient’s written consent is available for review by the Chief Editor of this journal.

Competing interests

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Carrión-Nessi, F.S., Mendoza-Millán, D.L., Omaña-Ávila, Ó.D. et al. Plasmodium vivax and SARS-CoV-2 co-infection in Venezuelan pregnant women: a case series. Malar J 22, 11 (2023). https://doi.org/10.1186/s12936-023-04442-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1186/s12936-023-04442-4

Keywords

  • Case series
  • COVID-19
  • Malaria
  • Plasmodium vivax
  • SARS-CoV-2
  • Venezuela

Malaria Journal

ISSN: 1475-2875

Contact us