{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,3]],"date-time":"2026-01-03T15:18:18Z","timestamp":1767453498688,"version":"build-2065373602"},"reference-count":116,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,2,19]],"date-time":"2023-02-19T00:00:00Z","timestamp":1676764800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>Strongyloides stercoralis is a soil transmitted helminth endemic to tropical and subtropical areas that can persist for decades in immunocompetent human hosts as a chronic asymptomatic infection. The use of corticosteroids, a mainstay of treatment for patients hospitalized with severe coronavirus disease (COVID-19), can trigger a life-threatening Strongyloides hyperinfection syndrome and disseminated disease. We identified 22 previously published cases of strongyloidiasis occurring in individuals with COVID-19, with one death reported among the seven patients who had Strongyloides hyperinfection syndrome. A total of seventeen patients had previously received corticosteroids, and of the five with no prior corticosteroid use, one presented with hyperinfection syndrome. We identify the key challenges in the diagnosis and treatment of Strongyloides within the context of COVID-19, including our imprecise knowledge of the global distribution of Strongyloides, the overlapping symptoms and signs of COVID-19 and Strongyloides hyperinfection syndrome, the limited utility of eosinophilia as a clinical marker for strongyloidiasis in this setting, the lack of validated algorithms to screen for Strongyloides prior to corticosteroid use, and the paucity of treatment options for critically ill patients with COVID-19 who cannot take oral ivermectin. Future research should focus on improved diagnostic methods and population prevalence estimates, optimizing the approaches for Strongyloides screening in persons with COVID-19 (including clinical trial participants and strategies for resource-limited settings) and better defining the role of pre-emptive treatment.<\/jats:p>","DOI":"10.3390\/tropicalmed8020127","type":"journal-article","created":{"date-parts":[[2023,2,20]],"date-time":"2023-02-20T01:36:37Z","timestamp":1676856997000},"page":"127","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Strongyloides and COVID-19: Challenges and Opportunities for Future Research"],"prefix":"10.3390","volume":"8","author":[{"given":"Daniel","family":"Seeger","sequence":"first","affiliation":[{"name":"Infectious Diseases Section, DC Veterans Affairs Medical Center, Washington, DC 20422, USA"},{"name":"Division of Infectious Diseases, School of Medicine and Health Sciences, George Washington University, Washington, DC 20052, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1987-1212","authenticated-orcid":false,"given":"Enrique","family":"Cornejo Cisneros","sequence":"additional","affiliation":[{"name":"Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, 15102, Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3856-7224","authenticated-orcid":false,"given":"Jose","family":"Lucar","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, School of Medicine and Health Sciences, George Washington University, Washington, DC 20052, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9197-1774","authenticated-orcid":false,"given":"Rachel","family":"Denyer","sequence":"additional","affiliation":[{"name":"Infectious Diseases Section, DC Veterans Affairs Medical Center, Washington, DC 20422, USA"},{"name":"Division of Infectious Diseases, School of Medicine and Health Sciences, George Washington University, Washington, DC 20052, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1017\/S0031182016000834","article-title":"Human infection with Strongyloides stercoralis and other related Strongyloides species","volume":"144","author":"Nutman","year":"2017","journal-title":"Parasitology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1007\/s15010-015-0799-1","article-title":"Strongyloides stercoralis hyperinfection syndrome: A case series and a review of the literature","volume":"43","author":"Geri","year":"2015","journal-title":"Infection"},{"doi-asserted-by":"crossref","unstructured":"Luvira, V., Siripoon, T., Phiboonbanakit, D., Somsri, K., Watthanakulpanich, D., and Dekumyoy, P. (2022). Strongyloides stercoralis: A Neglected but Fatal Parasite. Trop. Med. Infect. Dis., 7.","key":"ref_3","DOI":"10.3390\/tropicalmed7100310"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"4872473","DOI":"10.1155\/2016\/4872473","article-title":"Strongyloides stercoralis Infection in Alcoholic Patients","volume":"2016","author":"Teixeira","year":"2016","journal-title":"Biomed. Res. Int."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e3528","DOI":"10.6061\/clinics\/2021\/e3528","article-title":"COVID-19 and strongyloidiasis: What to expect from this coinfection?","volume":"76","author":"Pereira","year":"2021","journal-title":"Clinics"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1111\/j.1742-1241.1998.tb08926.x","article-title":"Disseminated strongyloidiasis arising from a single dose of dexamethasone before stereotactic radiosurgery","volume":"52","author":"Thomas","year":"1998","journal-title":"Int. J. Clin. Pract."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1163","DOI":"10.1016\/j.trstmh.2007.05.021","article-title":"Strongyloides stercoralis septicaemia following steroid therapy for eosinophilia: Report of three cases","volume":"101","author":"Ghosh","year":"2007","journal-title":"Trans. R. Soc. Trop. Med. Hyg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1016\/0002-9394(80)90179-8","article-title":"Subconjunctival corticosteroid therapy complicated by hyperinfective strongyloidiasis","volume":"89","author":"West","year":"1980","journal-title":"Am. J. Ophthalmol."},{"unstructured":"COVID-19 Excess Mortality Collaborators (2022). Estimating excess mortality due to the COVID-19 pandemic: A systematic analysis of COVID-19-related mortality, 2020\u20132021. Lancet, 399, 1513\u20131536.","key":"ref_9"},{"doi-asserted-by":"crossref","unstructured":"RECOVERY Collaborative Group, Horby, P., Lim, W.S., Emberson, J.R., Mafham, M., Bell, J.L., Linsell, L., Staplin, N., Brightling, C., and Ustianowski, A. (2021). Dexamethasone in Hospitalized Patients with COVID-19. N. Engl. J. Med., 384, 693\u2013704.","key":"ref_10","DOI":"10.1056\/NEJMoa2021436"},{"unstructured":"World Health Organization (2022, December 20). Corticosteroids for COVID-19: Living Guidance, 2 September 2020. World Health Organization. Available online: https:\/\/apps.who.int\/iris\/handle\/10665\/334125.","key":"ref_11"},{"unstructured":"COVID-19 Treatment Guidelines Panel (2022, December 30). Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. National Institutes of Health, Available online: https:\/\/www.covid19treatmentguidelines.nih.gov\/.","key":"ref_12"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.1093\/trstmh\/trab142","article-title":"Considering opportunistic parasitic infections in COVID-19 policies and recommendations","volume":"115","author":"Mewara","year":"2021","journal-title":"Trans. R. Soc. Trop. Med. Hyg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1186\/s13071-022-05284-w","article-title":"Mapping the global distribution of Strongyloides stercoralis and hookworms by ecological niche modeling","volume":"15","author":"Fleitas","year":"2022","journal-title":"Parasites Vectors"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1531","DOI":"10.3201\/eid2807.220198","article-title":"Strongyloides Hyperinfection Syndrome among COVID-19 Patients Treated with Corticosteroids","volume":"28","author":"Kim","year":"2022","journal-title":"Emerg. Infect. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e01192","DOI":"10.1016\/j.idcr.2021.e01192","article-title":"Corticosteroids in Covid-19 pandemic have the potential to unearth hidden burden of strongyloidiasis","volume":"25","author":"Gautam","year":"2021","journal-title":"IDCases"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1590","DOI":"10.4269\/ajtmh.20-0699","article-title":"Case Report: Disseminated Strongyloidiasis in a Patient with COVID-19","volume":"103","author":"Lier","year":"2020","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1134","DOI":"10.4269\/ajtmh.21-0677","article-title":"Strongyloidiasis: An Important Coinfection in the COVID-19 Era","volume":"105","author":"Comeche","year":"2021","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_19","first-page":"591","article-title":"Strongyloides Hyperinfection Syndrome in a Patient with Asymptomatic COVID-19 Infection","volume":"115","author":"Gillis","year":"2022","journal-title":"Ir. Med. J."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"267","DOI":"10.30699\/ijmm.16.3.267","article-title":"Strongyloides Hyperinfection Syndrome Following Corticosteroid Therapy in a Patient with COVID-19 infection: A Case Report","volume":"16","author":"Babazadeh","year":"2022","journal-title":"Iran. J. Med. Microbiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"A278","DOI":"10.1016\/j.chest.2021.07.285","article-title":"A Case of Disseminated Strongyloidiasis During Treatment for COVID-19","volume":"160","author":"Patel","year":"2021","journal-title":"Chest"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1007\/s15010-020-01522-4","article-title":"Strongyloides infection manifested during immunosuppressive therapy for SARS-CoV-2 pneumonia","volume":"49","author":"Marchese","year":"2021","journal-title":"Infection"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1016\/j.medcli.2021.05.004","article-title":"Reactivation of Strongyloides stercoralis in patients with SARS-CoV-2 pneumonia receiving dexamethasone","volume":"158","author":"Feria","year":"2022","journal-title":"Med. Clin."},{"key":"ref_24","first-page":"478","article-title":"Eosinophilia and abdominal pain after severe pneumonia due to COVID 19","volume":"39","year":"2021","journal-title":"Enferm. Infecc. Microbiol. Clin."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"015","DOI":"10.17352\/2455-5282.000148","article-title":"Activating dormant strongyloidiasis secondary to COVID-19 treatment","volume":"9","author":"Alkaabba","year":"2022","journal-title":"Glob. J. Med. Clin. Case Rep."},{"doi-asserted-by":"crossref","unstructured":"Busaidi, N., Al-Farsi, F., Batashi, H., Kashoub, M., Sinani, A., Balushi, Z., and Khamis, F. (2022). Steroid-induced Strongyloidiasis with Cholestasis Post-COVID-19 Pneumonia. Oman Med. J.","key":"ref_26","DOI":"10.5001\/omj.2023.31"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e305","DOI":"10.1097\/IPC.0000000000000991","article-title":"COVID-19\u2014Associated eosinopenia in a patient with chronic eosinophilia due to chronic strongyloidiasis","volume":"29","author":"Stylemans","year":"2021","journal-title":"Infect. Dis. Clin. Pract."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1099","DOI":"10.2217\/fmb-2022-0027","article-title":"Coinfection with Strongyloides and Ascaris in a COVID-19-positive male presenting with acute abdomen: A case report","volume":"17","author":"Singh","year":"2022","journal-title":"Future Microbiol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1093\/trstmh\/trab152","article-title":"Influence of the drugs used in migrant patients with severe acute respiratory syndrome coronavirus 2 and the development of symptomatic strongyloidiasis","volume":"116","author":"Lorenzo","year":"2022","journal-title":"Trans. R Soc. Trop. Med. Hyg."},{"doi-asserted-by":"crossref","unstructured":"Buonfrate, D., Bisanzio, D., Giorli, G., Odermatt, P., F\u00fcrst, T., Greenaway, C., French, M., Reithinger, R., Gobbi, F., and Montresor, A. (2020). The Global Prevalence of Strongyloides stercoralis Infection. Pathogens, 9.","key":"ref_30","DOI":"10.3390\/pathogens9060468"},{"doi-asserted-by":"crossref","unstructured":"Sch\u00e4r, F., Trostdorf, U., Giardina, F., Khieu, V., Muth, S., Marti, H., Vounatsou, P., and Odermatt, P. (2013). Strongyloides stercoralis: Global Distribution and Risk Factors. PLoS Negl Trop. Dis., 11.","key":"ref_31","DOI":"10.1371\/journal.pntd.0002288"},{"doi-asserted-by":"crossref","unstructured":"Prasongdee, T.K., Laoraksawong, P., Kanarkard, W., Kraiklang, R., Sathapornworachai, K., Naonongwai, S., Laummaunwai, P., Sanpool, O., Intapan, P.M., and Maleewong, W. (2017). An eleven-year retrospective hospital-based study of epidemiological data regarding human strongyloidiasis in northeast Thailand. BMC Infect. Dis., 17.","key":"ref_32","DOI":"10.1186\/s12879-017-2723-z"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1186\/s40249-020-00750-y","article-title":"Strongyloides stercoralis prevalence and diagnostics in Vientiane, Lao People\u2019s Democratic Republic","volume":"9","author":"Chankongsin","year":"2020","journal-title":"Infect. Dis. Poverty"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"313","DOI":"10.4269\/ajtmh.1982.31.313","article-title":"Epidemiologic features of Strongyloides stercoralis infection in an endemic area of the United States","volume":"31","author":"Walzer","year":"1982","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1000","DOI":"10.4269\/ajtmh.14-0310","article-title":"Prevalence of Strongyloides stercoralis antibodies among a rural Appalachian population\u2014Kentucky, 2013","volume":"91","author":"Russell","year":"2014","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1016\/j.ijid.2020.09.002","article-title":"Modeling strongyloidiasis risk in the United States","volume":"100","author":"Singer","year":"2020","journal-title":"Int. J. Infect. Dis."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"339","DOI":"10.12659\/AJCR.902626","article-title":"Strongyloides Stercoralis infection among Human Immunodeficiency Virus (HIV)-infected patients in the United States of America: A Case Report and Review of Literature","volume":"18","author":"Saul","year":"2017","journal-title":"Am. J. Case Rep."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1623","DOI":"10.4269\/ajtmh.17-0396","article-title":"Human intestinal parasite burden and poor sanitation in rural Alabama","volume":"97","author":"McKenna","year":"2017","journal-title":"Am. J. Trop. Med. Hyg."},{"doi-asserted-by":"crossref","unstructured":"Puthiyakunnon, S., Boddu, S., Li, Y., Zhou, X., Wang, C., Li, J., and Chen, X. (2014). Strongyloidiasis\u2014An insight into its global prevalence and management. PLoS Negl. Trop. Dis., 8.","key":"ref_39","DOI":"10.1371\/journal.pntd.0003018"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1093\/trstmh\/trt053","article-title":"North Metropolitan Working Group on Imported Diseases. Strongyloides stercoralis, the hidden worm. Epidemiological and clinical characteristics of 70 cases diagnosed in the North Metropolitan Area of Barcelona, Spain, 2003\u20132012","volume":"107","author":"Valerio","year":"2013","journal-title":"Trans. R. Soc. Trop. Med. Hyg."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e236","DOI":"10.1016\/S2214-109X(18)30490-X","article-title":"Prevalence of strongyloidiasis and schistosomiasis among migrants: A systematic review and meta-analysis","volume":"7","author":"Asundi","year":"2019","journal-title":"Lancet Glob. Health"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1310","DOI":"10.1086\/522529","article-title":"High prevalence and presumptive treatment of schistosomiasis and strongyloidiasis among African refugees","volume":"45","author":"Posey","year":"2007","journal-title":"Clin. Infect. Dis."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1177\/14034948211019795","article-title":"Learning from the COVID-19 pandemic among migrants: An innovative, system-level, interdisciplinary approach is needed to improve public health","volume":"49","author":"Diaz","year":"2021","journal-title":"Scand. J. Public Health"},{"unstructured":"(2023, January 10). Migration Data Portal. Available online: https:\/\/www.migrationdataportal.org\/themes\/migration-data-relevant-covid-19-pandemic.","key":"ref_44"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.idc.2018.10.006","article-title":"Strongyloidiasis: A Neglected Tropical Disease","volume":"33","author":"Krolewiecki","year":"2019","journal-title":"Infect. Dis. Clin. N. Am."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1021\/acsptsci.0c00141","article-title":"Helminths and COVID-19 Co-Infections: A Neglected Critical Challenge","volume":"3","author":"Abdoli","year":"2020","journal-title":"ACS Pharmacol. Transl. Sci."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"E540","DOI":"10.1503\/cmaj.202604","article-title":"The impact of COVID-19 on pregnancy outcomes: A systematic review and meta-analysis","volume":"193","author":"Wei","year":"2021","journal-title":"CMAJ"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1184","DOI":"10.1017\/S0031182020000979","article-title":"Machine learning-based analyses support the existence of species complexes for Strongyloides fuelleborni and Strongyloides stercoralis","volume":"147","author":"Barratt","year":"2020","journal-title":"Parasitology"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1186\/s13059-020-02020-4","article-title":"Lifestyle and the presence of helminths is associated with gut microbiome composition in Cameroonians","volume":"21","author":"Rubel","year":"2020","journal-title":"Genome Biol."},{"doi-asserted-by":"crossref","unstructured":"Araujo Navas, A.L., Hamm, N.A., Soares Magalh\u00e3es, R.J., and Stein, A. (2016). Mapping Soil Transmitted Helminths and Schistosomiasis under Uncertainty: A Systematic Review and Critical Appraisal of Evidence. PLoS Negl. Trop. Dis., 10.","key":"ref_50","DOI":"10.1371\/journal.pntd.0005208"},{"doi-asserted-by":"crossref","unstructured":"RECOVERY Collaborative Group (2021). Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): A randomised, controlled, open-label, platform trial. Lancet, 397, 1637\u20131645.","key":"ref_51","DOI":"10.1101\/2021.02.11.21249258"},{"doi-asserted-by":"crossref","unstructured":"REMAP-CAP Investigators (2021). Interleukin-6 Receptor Antagonists in Critically Ill Patients with COVID-19. N. Engl. J. Med., 384, 1491\u20131502.","key":"ref_52","DOI":"10.1056\/NEJMoa2100433"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"R141","DOI":"10.1186\/ar3455","article-title":"Integrated safety in tocilizumab clinical trials","volume":"13","author":"Schiff","year":"2011","journal-title":"Arthritis Res. Ther."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"S21","DOI":"10.1016\/j.cmi.2018.02.002","article-title":"ESCMID Study Group for Infections in Compromised Hosts (ESGICH) Consensus Document on the safety of targeted and biological therapies: An infectious diseases perspective (Soluble immune effector molecules [II]: Agents targeting interleukins, immunoglobulins and complement factors)","volume":"24","author":"Winthrop","year":"2018","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1752","DOI":"10.1038\/s41591-021-01499-z","article-title":"Early treatment of COVID-19 with anakinra guided by soluble urokinase plasminogen receptor plasma levels: A double-blind, randomized controlled phase 3 trial","volume":"10","author":"Kyriazopoulou","year":"2021","journal-title":"Nat. Med."},{"key":"ref_56","first-page":"302","article-title":"Interleukin-1 receptor antagonist (anakinra) treatment in patients with systemic-onset juvenile idiopathic arthritis or adult onset Still disease: Preliminary experience in France","volume":"67","author":"Quartier","year":"2008","journal-title":"Ann. Rheum Dis."},{"doi-asserted-by":"crossref","unstructured":"RECOVERY Collaborative Group (2022). Baricitinib in patients admitted to hospital with COVID-19 (RECOVERY): A randomised, controlled, open-label, platform trial and updated meta-analysis. Lancet, 400, 359\u2013368.","key":"ref_57","DOI":"10.1101\/2022.03.02.22271623"},{"unstructured":"COV-BARRIER Study Group (2021). Efficacy and safety of baricitinib for the treatment of hospitalised adults with COVID-19 (COV-BARRIER): A randomised, double-blind, parallel-group, placebo-controlled phase 3 trial. Lancet Respir. Med., 9, 1407\u20131418.","key":"ref_58"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"759","DOI":"10.15585\/mmwr.mm6924e2","article-title":"Coronavirus Disease 2019 Case Surveillance\u2014United States, January 22\u2013May 30, 2020","volume":"69","author":"Stokes","year":"2020","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.1016\/j.jaad.2013.11.036","article-title":"Rapid development of migratory, linear, and serpiginous lesions in association with immunosuppression","volume":"70","author":"Pichard","year":"2014","journal-title":"J. Am. Acad Dermatol."},{"key":"ref_61","first-page":"e13844","article-title":"Comment on \u201cAre erythema multiforme and urticaria related to a better outcome of COVID 19?\u201d Eosinophil count in seven patients with COVID-19 and urticarial rash","volume":"33","year":"2020","journal-title":"Dermatol. Ther."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.4269\/ajtmh.18-0895","article-title":"Morbidity Associated with Chronic Strongyloides stercoralis Infection: A Systematic Review and Meta-Analysis","volume":"100","author":"Tamarozzi","year":"2019","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1118","DOI":"10.1016\/j.jaad.2020.06.1016","article-title":"The spectrum of COVID-19-associated dermatologic manifestations: An international registry of 716 patients from 31 countries","volume":"83","author":"Freeman","year":"2020","journal-title":"J. Am. Acad Dermatol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"537","DOI":"10.2214\/ajr.162.3.8109492","article-title":"Pulmonary strongyloidiasis: Clinical and imaging features","volume":"162","author":"Woodring","year":"1994","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"E289","DOI":"10.1148\/radiol.2020202504","article-title":"Review of the Chest CT Differential Diagnosis of Ground-Glass Opacities in the COVID Era","volume":"297","author":"Parekh","year":"2020","journal-title":"Radiology"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1100","DOI":"10.1016\/j.chest.2019.12.025","article-title":"Pictorial Review of Thoracic Parasitic Diseases: A Radiologic Guide","volume":"157","author":"Fiorentini","year":"2020","journal-title":"Chest"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1016\/j.jacr.2020.03.006","article-title":"Coronavirus Disease 2019 (COVID-19) CT Findings: A Systematic Review and Meta-analysis","volume":"17","author":"Bao","year":"2020","journal-title":"J. Am. Coll. Radiol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"2038","DOI":"10.1016\/j.mayocp.2020.06.023","article-title":"Migratory Pulmonary Infiltrates in a Patient With COVID-19 Infection and the Role of Corticosteroids","volume":"95","author":"John","year":"2020","journal-title":"Mayo Clin. Proc."},{"key":"ref_69","first-page":"e20200528","article-title":"Migratory pulmonary infiltrates in a patient with COVID-19 and lymphoma","volume":"47","author":"Santana","year":"2021","journal-title":"J. Bras. Pneumol."},{"doi-asserted-by":"crossref","unstructured":"Musuuza, J.S., Watson, L., Parmasad, V., Putman-Buehler, N., Christensen, L., and Safdar, N. (2021). Prevalence and outcomes of co-infection and superinfection with SARS-CoV-2 and other pathogens: A systematic review and meta-analysis. PLoS ONE, 16.","key":"ref_70","DOI":"10.1371\/journal.pone.0251170"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1621","DOI":"10.1016\/j.cmi.2021.07.016","article-title":"Clinical and laboratory features of Strongyloides stercoralis infection at diagnosis and after treatment: A systematic review and meta-analysis","volume":"27","author":"Buonfrate","year":"2021","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1128\/CMR.17.1.208-217.2004","article-title":"Strongyloides stercoralis in the Immunocompromised Population","volume":"17","author":"Keiser","year":"2004","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"1372","DOI":"10.1164\/rccm.202003-0543OC","article-title":"Clinical features of 85 fatal cases of COVID-19 from Wuhan. A retrospective observational study","volume":"201","author":"Du","year":"2020","journal-title":"Am. J. Respir Crit Care Med."},{"doi-asserted-by":"crossref","unstructured":"Tanni, F., Akker, E., Zaman, M.M., Figueroa, N., Tharian, B., and Hupart, K.H. (2020). Eosinopenia and COVID-19. J. Am. Osteopath Assoc., epub ahead of print.","key":"ref_74","DOI":"10.7556\/jaoa.2020.091"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"100375","DOI":"10.1016\/j.eclinm.2020.100375","article-title":"Eosinopenia and elevated C-reactive protein facilitate triage of Covid-19 patients in fever clinic: A retrospective case-control study","volume":"23","author":"Li","year":"2020","journal-title":"EClinicalMedicine"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/j.ijid.2020.03.013","article-title":"Patients of COVID-19 may benefit from sustained lopinavir-combined regimen and the increase of eosinophil may predict the outcome of COVID-19 progression","volume":"95","author":"Liu","year":"2020","journal-title":"Int. J. Infect. Dis."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1111\/all.14465","article-title":"The role of peripheral blood eosinophil counts in COVID-19 patients","volume":"76","author":"Xie","year":"2021","journal-title":"Allergy"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1016\/j.jaip.2020.09.039","article-title":"Benralizumab for severe DRESS in two COVID-19 patients","volume":"9","author":"Steiger","year":"2021","journal-title":"J. Allergy Clin. Immunol Pract."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"2086","DOI":"10.3389\/fimmu.2020.02086","article-title":"COVID-19 in a severely immunosuppressed patient with life-threatening eosinophilic granulomatosis with polyangiitis","volume":"11","author":"Schramm","year":"2020","journal-title":"Front. Immunol."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"2569","DOI":"10.1128\/jcm.34.10.2569-2571.1996","article-title":"Patterns of detection of Strongyloides stercoralis in stool specimens: Implications for diagnosis and clinical trials","volume":"34","author":"Dreyer","year":"1996","journal-title":"J. Clin. Microbiol."},{"doi-asserted-by":"crossref","unstructured":"Gataz, L., Castro, R., Zamora, P., Kramer, M., Gareca, N., Torrico-Espinoza, M., Macias, J., Lisarazu-Valasquez, S., Rodriguez, G., and Valencia-Rivero, C. (2019). Epidemiology of Strongyloides stercoralis infection in Bolivian patients at high risk of complications. PLoS Negl. Trop. Dis., 13.","key":"ref_81","DOI":"10.1371\/journal.pntd.0007028"},{"doi-asserted-by":"crossref","unstructured":"Meurs, L., Polderman, A.M., Melchers, N.V.S.V., Brienen, E.A.T., Verweij, J.J., Groosjohan, B., Mendes, F., Mechendura, M., Hepp, D.H., and Langenberg, M.C.C. (2017). Diagnosing Polyparasitism in a High-Prevalence Setting in Beira, Mozambique: Detection of Intestinal Parasites in Fecal Samples by Microscopy and Real-Time PCR. PLoS Negl. Trop. Dis., 11.","key":"ref_82","DOI":"10.1371\/journal.pntd.0005310"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"401","DOI":"10.4269\/ajtmh.16-0068","article-title":"Comparative Diagnosis of Strongyloidiasis in Immunocompromised Patients","volume":"95","author":"Luvira","year":"2016","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1007\/s11908-008-0019-6","article-title":"Strongyloides stercoralis infection in the immunocompromised host","volume":"10","author":"Ramanathan","year":"2008","journal-title":"Curr. Infect. Dis Rep."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"taab155","DOI":"10.1093\/jtm\/taab155","article-title":"Strongyloidiasis in immunocompromised migrants to non-endemic countries in the era of COVID-19: What is the role for presumptive ivermectin?","volume":"29","author":"Barkati","year":"2022","journal-title":"J. Travel Med."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"545.e1","DOI":"10.1016\/j.amjmed.2006.05.072","article-title":"Maltreatment of Strongyloides infection: Case series and worldwide physicians-in-training survey","volume":"120","author":"Boulware","year":"2007","journal-title":"Am. J. Med."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1001\/jama.2020.13170","article-title":"COVID-19 and Dexamethasone: A potential strategy to avoid steroid-related Strongyloides hyperinfection","volume":"324","author":"Stauffer","year":"2020","journal-title":"JAMA"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"12","DOI":"10.14745\/ccdr.v42i01a03","article-title":"Committee to Advise on Tropical Medicine; Travel (CATMAT). CATMAT statement on disseminated strongyloidiasis: Prevention, assessment and management guidelines","volume":"42","author":"Boggild","year":"2016","journal-title":"Can. Commun. Dis. Rep."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"101981","DOI":"10.1016\/j.tmaid.2021.101981","article-title":"Risk of Strongyloides hyperinfection syndrome when prescribing dexamethasone in severe COVID-19","volume":"40","author":"Nabarro","year":"2021","journal-title":"Travel. Med. Infect. Dis."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.1007\/s10903-021-01225-4","article-title":"Preventing Infectious Complications of Immunomodulation in COVID-19 in Foreign-Born Patients","volume":"23","author":"Mohareb","year":"2021","journal-title":"J. Immigr Minor. Health"},{"doi-asserted-by":"crossref","unstructured":"Carnino, L., Schwob, J.M., G\u00e9taz, L., Nickel, B., Neumayr, A., and Eperon, G. (2021). A Practical Approach to Screening for Strongyloides stercoralis. Trop. Med. Infect. Dis., 6.","key":"ref_91","DOI":"10.3390\/tropicalmed6040203"},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"1611","DOI":"10.4269\/ajtmh.20-1085","article-title":"Dexamethasone and COVID-19: Strategies in Low- and Middle-Income Countries to Tackle Steroid-Related Strongyloides Hyperinfection","volume":"104","author":"Olivera","year":"2021","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"1431","DOI":"10.1007\/s10903-022-01386-w","article-title":"Strongyloidiasis Hyperinfection Syndrome in COVID-19 Positive Migrants Treated with Corticosteroids","volume":"24","author":"Jenks","year":"2022","journal-title":"J. Immigr. Minor. Health"},{"doi-asserted-by":"crossref","unstructured":"Rodr\u00edguez-Guardado, A., \u00c1lvarez-Mart\u00ednez, M.J., Flores, M.D., Sulleiro, E., Torr\u00fas-Tendero, D., Velasco, M., and Membrillo, F.J. (2022). Imported Pathology Group of the SEIMC. Screening for strongyloidiasis in Spain in the context of the SARS-CoV-2 pandemic: Results of a survey on diagnosis and treatment. Enferm. Infecc. Microbiol. Clin., in press.","key":"ref_94","DOI":"10.1016\/j.eimce.2022.08.006"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"101054","DOI":"10.1016\/j.eclinm.2021.101054","article-title":"Effect of co-infection with intestinal parasites on COVID-19 severity: A prospective observational cohort study","volume":"39","author":"Wolday","year":"2021","journal-title":"EClinicalMedicine"},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1007\/s15010-021-01621-w","article-title":"Strongyloidiasis in the COVID era: A warning for an implementation of the screening protocol","volume":"49","author":"Vellere","year":"2021","journal-title":"Infection"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1007\/s00408-022-00528-z","article-title":"Strongyloides stercoralis","volume":"2","author":"Czeresnia","year":"2022","journal-title":"Lung"},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1016\/S1473-3099(19)30289-0","article-title":"Multiple-dose versus single-dose ivermectin for Strongyloides stercoralis infection (Strong Treat 1 to 4): A multicentre, open-label, phase 3, randomised controlled superiority trial","volume":"19","author":"Buonfrate","year":"2019","journal-title":"Lancet Infect. Dis."},{"key":"ref_99","first-page":"A115","article-title":"4CPS-405\u2005Strongyloides stercoralis prophylaxis with ivermectin in COVID-19 patients","volume":"28","author":"Garcia","year":"2021","journal-title":"Eur. J. Hosp. Pharm."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1097\/QCO.0b013e3283551dbd","article-title":"Screening, prevention, and treatment for hyperinfection syndrome and disseminated infections caused by Strongyloides stercoralis","volume":"25","author":"Mejia","year":"2012","journal-title":"Curr. Opin Infect. Dis."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"1617","DOI":"10.1080\/14656566.2022.2114829","article-title":"Current pharmacotherapeutic strategies for Strongyloidiasis and the complications in its treatment","volume":"23","author":"Buonfrate","year":"2022","journal-title":"Expert Opin. Pharmacother."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"e223079","DOI":"10.1001\/jamanetworkopen.2022.3079","article-title":"Comparison of Trials Using Ivermectin for COVID-19 between Regions With High and Low Prevalence of Strongyloidiasis: A Meta-analysis","volume":"5","author":"Bitterman","year":"2022","journal-title":"JAMA Netw. Open"},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1038\/d41586-020-02958-2","article-title":"Latin America\u2019s embrace of an unproven COVID treatment is hindering drug trials","volume":"586","year":"2020","journal-title":"Nature"},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"4421","DOI":"10.2147\/IDR.S335447","article-title":"The Influence of Helminth Immune Regulation on COVID-19 Clinical Outcomes: Is it Beneficial or Detrimental?","volume":"14","author":"Ademe","year":"2021","journal-title":"Infect. Drug Resist."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"706902","DOI":"10.3389\/fgene.2021.706902","article-title":"Th2\/Th1 Cytokine Imbalance Is Associated With Higher COVID-19 Risk Mortality","volume":"12","author":"Pavel","year":"2021","journal-title":"Front. Genet."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"2195","DOI":"10.3389\/fimmu.2020.02195","article-title":"Impact of Helminth Infection on Metabolic and Immune Homeostasis in Non-diabetic Obesity","volume":"11","author":"Rajamanickam","year":"2020","journal-title":"Front. Immunol."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"574910","DOI":"10.3389\/fimmu.2020.574910","article-title":"COVID-19 Lethality in Sub-Saharan Africa and Helminth Immune Modulation","volume":"11","author":"Fonte","year":"2020","journal-title":"Front. Immunol."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"2598","DOI":"10.1128\/IAI.72.5.2598-2604.2004","article-title":"Impairment of tetanus-specific cellular and humoral responses following tetanus vaccination in human lymphatic filariasis","volume":"72","author":"Nookala","year":"2004","journal-title":"Infect. Immun."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1093\/infdis\/173.1.269","article-title":"Impairment of tetanus toxoid-specific Th1-like immune responses in humans infected with Schistosoma mansoni","volume":"173","author":"Sabin","year":"1996","journal-title":"J Infect. Dis."},{"doi-asserted-by":"crossref","unstructured":"Nouatin, O., Mengue, J.B., Dejon-Agob\u00e9, J.C., Fendel, R., Ib\u00e1\u00f1ez, J., Ngoa, U.A., Edoa, J.R., Ad\u00e9gbit\u00e9, B.R., Honkp\u00e9h\u00e9dji, Y.J., and Zinsou, J.F. (2021). Exploratory analysis of the effect of helminth infection on the immunogenicity and efficacy of the asexual blood-stage malaria vaccine candidate GMZ2. PLoS Negl. Trop. Dis., 15.","key":"ref_110","DOI":"10.1371\/journal.pntd.0009361"},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"5582","DOI":"10.1016\/j.vaccine.2020.06.064","article-title":"Do parasite infections interfere with immunisation? A review and meta-analysis","volume":"38","author":"Wait","year":"2020","journal-title":"Vaccine"},{"doi-asserted-by":"crossref","unstructured":"Br\u00fcckner, S., Agnandji, S.T., Berberich, S., Bache, E., Fernandes, J.F., Schweiger, B., Massinga Loembe, M., Engleitner, T., Lell, B., and Mordm\u00fcller, B. (2015). Effect of Antihelminthic Treatment on Vaccine Immunogenicity to a Seasonal Influenza Vaccine in Primary School Children in Gabon: A Randomized Placebo-Controlled Trial. PLoS Negl. Trop. Dis., 9.","key":"ref_112","DOI":"10.1371\/journal.pntd.0003768"},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"102087","DOI":"10.1016\/j.tmaid.2021.102087","article-title":"Emerging issues in COVID-19 vaccination in tropical areas: Impact of the immune response against helminths in endemic areas","volume":"42","year":"2021","journal-title":"Travel Med. Infect. Dis."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"e0171721","DOI":"10.1128\/JCM.01717-21","article-title":"Specificity of SARS-CoV-2 Antibody Detection Assays against S and N Proteins among Pre-COVID-19 Sera from Patients with Protozoan and Helminth Parasitic Infections","volume":"60","author":"Yansouni","year":"2022","journal-title":"J. Clin. Microbiol."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"1222","DOI":"10.3389\/fmicb.2017.01222","article-title":"Tuftsin-Phosphorylcholine Maintains Normal Gut Microbiota in Collagen Induced Arthritic Mice","volume":"8","author":"Bashi","year":"2017","journal-title":"Front. Microbiol."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"100552","DOI":"10.1016\/j.epidem.2022.100552","article-title":"Recalibrating the notion of modelling for policymaking during pandemics","volume":"38","author":"Teerawattananon","year":"2022","journal-title":"Epidemics"}],"container-title":["Tropical Medicine and Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2414-6366\/8\/2\/127\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:36:40Z","timestamp":1760121400000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2414-6366\/8\/2\/127"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,19]]},"references-count":116,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["tropicalmed8020127"],"URL":"https:\/\/doi.org\/10.3390\/tropicalmed8020127","relation":{},"ISSN":["2414-6366"],"issn-type":[{"type":"electronic","value":"2414-6366"}],"subject":[],"published":{"date-parts":[[2023,2,19]]}}}