We read with extreme interest the recent case report by Marchese et al. concerning the manifestation of Strongyloides stercoralis infection during immunosuppressive therapy for COVID-19 [1]. As a matter of fact, dexamethasone has clearly shown to reduce mortality for COVID-19 in a randomized clinical trial [2]. More recently, international trials showed a benefit in terms of survival with the use of IL-6 antagonists, such as tocilizumab and sarilumab [3, 4]. Moreover, additional treatment options, such as higher dose of corticosteroids and other immunosuppressive drugs, are being evaluated in clinical trials, used off-label or in the context of compassionate programs [5]. The risk of reactivation of latent infections in COVID-19 patients treated with such medications may be considered limited if compared to that of patients with chronic immune-mediated diseases, since treatment course is usually shorter. However, no specific studies have addressed this point so far.
Strongyloidiasis in the COVID era: a warning for an implementation of the screening protocol / Vellere I.; Graziani L.; Tilli M.; Mantella A.; Campolmi I.; Mencarini J.; Borchi B.; Spinicci M.; Antonelli A.; Rossolini G.M.; Bartoloni A.; Zammarchi L.. - In: INFECTION. - ISSN 0300-8126. - ELETTRONICO. - (2021), pp. 1-3. [10.1007/s15010-021-01621-w]
Strongyloidiasis in the COVID era: a warning for an implementation of the screening protocol
Vellere I.;Graziani L.;Tilli M.;Mantella A.;Campolmi I.;Mencarini J.;Spinicci M.;Antonelli A.;Rossolini G. M.;Bartoloni A.;Zammarchi L.
2021
Abstract
We read with extreme interest the recent case report by Marchese et al. concerning the manifestation of Strongyloides stercoralis infection during immunosuppressive therapy for COVID-19 [1]. As a matter of fact, dexamethasone has clearly shown to reduce mortality for COVID-19 in a randomized clinical trial [2]. More recently, international trials showed a benefit in terms of survival with the use of IL-6 antagonists, such as tocilizumab and sarilumab [3, 4]. Moreover, additional treatment options, such as higher dose of corticosteroids and other immunosuppressive drugs, are being evaluated in clinical trials, used off-label or in the context of compassionate programs [5]. The risk of reactivation of latent infections in COVID-19 patients treated with such medications may be considered limited if compared to that of patients with chronic immune-mediated diseases, since treatment course is usually shorter. However, no specific studies have addressed this point so far.
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