DISSEMINATED STRONGYLOIDIASIS IN PATIENTS DIAGNOSED WITH COVID-19 TREATED WITH CORTICOIDS
Abstract
The arrival of a new epidemic at the end of 2019 occurred with an outbreak of new cases of people with a clinical picture that ranged from a common cold to serious complications, which included severe acute respiratory syndrome (SARS). With the rapid increase in the number of infected cases, new therapeutic strategies were devised. Among them, the use of corticosteroids is highlighted as a potential reducer of the inflammatory processes caused by the disease, particularly its effect on respiration, which proved to be an important part of the pathogenesis of the disease. The use of glucocorticoids in the treatment of COVID-19, while being efficient, presents problems such as the development of severe strongyloidiasis, especially in those patients who live or have lived in endemic areas for the parasitosis, and thus screening for this condition before therapy is the best immunosuppressive procedure. The evolution to disseminated strongyloidiasis or to hyperinfection in patients co-infected with SARS-CoV-2 undergoing treatment with glucocorticoids increases in chronic, asymptomatic carriers without a previous diagnosis of Strongyloides stercoralis, and this is due to the corticosteroid stimulus of the parasite larvae. Corticosteroids are an important risk factor for the development of S. stercoralis hyperinfection, which apparently does not depend on the dosage used or duration of treatment. After diagnostic confirmation or after establishing the risk through epidemiological stratification, these patients can be submitted to prophylactic treatment with ivermectin. Therefore, as many patients with COVID-19 are undergoing glucocorticoid therapy and these medications increase the risk of developing strongyloidiasis (disseminated form and form of hyperinfection), especially in risk patients, this study was carried out in the context of this approach theme of the coexistence of this parasitological infection and viral infection by SARS-CoV-2 in patients using the aforementioned immunosuppressive therapy. This is a literature review based on the main data platforms, through which 36 articles published between the years 2020 and 2022 were included for analysis.
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