key: cord-0743602-xicvf2j5
authors: Kishore, Rashmi; Dhakad, Shivram; Arif, Nazneen; Dar, Lalit; Mirdha, B. R.; Aggarwal, Richa; Kabra, S. K.
title: COVID-19: Possible Cause of Induction of Relapse of Plasmodium vivax Infection
date: 2020-07-03
journal: Indian J Pediatr
DOI: 10.1007/s12098-020-03441-6
sha: 6ee30ca44e932325941e42b9bbfdd6479065b5db
doc_id: 743602
cord_uid: xicvf2j5

nan

The child was admitted and treated for malaria and supportive care for COVID-19 infection [1] . Primaquine eradication therapy was given for 14 d after ruling out G6PD deficiency. He was discharged after complete recovery.

This boy had been diagnosed with P. vivax infection six months back and had now reactivation of malaria. Relapse rates after P. vivax infection vary geographically from 8 to 80%, with considerable proportion of population harboring dormant but activatable hypnozoites in endemic areas [2] . Exact mechanism causing this activation is though unclear, associated cytokine response with systemic illness has been postulated in P vivax relapse [3] . COVID-19 leads to a cytokine storm, which is responsible for the more severe manifestations of the disease [4, 5] . Hence, we postulate that the COVID-19 infection, with its cytokine response was responsible for induction of P. vivax relapse in our patient. Our hypothesis is based on circumstantial evidence in form of documented malaria in past, a possibility of re-activation in natural course or re-infection cannot be ruled out.

COVID-19 in children: clinical approach and management

World Health Organization. Guidelines for the Treatment of Malaria

Determinants of relapse periodicity in plasmodium vivax malaria

The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak-an update on the status

Pathological findings of COVID-19 associated with acute respiratory distress syndrome

Acknowledgments Director General, Indian Council of Medical Research, for providing funding for support of diagnostics.

Conflict of Interest None.