Helminthic therapy and COVID-19

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Helminths may confer protection against COVID-19

Someone who contracts SARS-CoV-2 and develops COVID-19 may recover from the illness more quickly and face a reduced risk of fatality if they are hosting helminths.

... we believe that chronic helminth infection provides infected people with an unexpected wealth of protective mechanisms against the Covid-19 disease and its lethal complications. [1]

The most severe symptoms (of COVID-19) are associated with overactive inflammatory immune responses, leading to a cytokine storm, tissue damage, and death, if not balanced and controlled… Soil transmitted helminths stimulate the immunosuppressive and regulatory T-helper 2 (TH2) branch of the immune system, which decreases ACE2-receptor expression (i.e., receptors SARS-CoV-2 uses to infect host cells), balances the inflammatory TH1/TH17 branches of the immune system triggered by SARS-CoV-2 infection, and reduces inflammation through the release of anti-inflammatory/regulatory cytokines.” [2]

Hookworm antigens are known to up-regulate genes belonging to certain families, including P53, that are responsible for programmed cell death. [3] In other research, it was found that P53 reduces replication of the SARS-CoV by 65%. [4]

The emerging science

• 2021 Apr 16 Interrogating the Impact of Intestinal Parasite-Microbiome on Pathogenesis of COVID-19 in Sub-Saharan Africa -- Full text | PDF

Here, we propose that the interplay between intestinal parasites and microbiome may have a potential direct or indirect effects on the pathogenesis of SARS-CoV-2 infection, in particular in the context of Low- and Middle-Income Countries.

• 2021 Feb 12 Between a hygiene rock and a hygienic hard place: Avoiding SARS-CoV-2 while needing environmental exposures for immunity — Full text | PDF

Evidence not only points to humans’ need of helminths for effective immune function, but also for an effective immune response against SARS-CoV-2 and other viral infections.

• 2021 Feb 2 Effect of co-infection with parasites on severity of COVID-19 -- PDF (medRxiv preprints)

Pre-existing infection with either protozoan parasites or helminths appears to be associated with reduced COVID-19 severity.

(Related media article: Research shows intestinal parasite infestations reduce COVID-19 severity - Liji Thomas, News Medical)

• 2020 Oct 20 Old Friends Meet a New Foe – A potential role for immune-priming parasites in mitigating COVID-19 morbidity and mortality -- Full text | PDF

An evolutionary perspective is required to understand the global impact and various presentations of COVID-19. We consider how coinfection with soil-transmitted helminths (common parasitic worms that coevolved with humans) may suppress inflammatory immune activity, thereby potentially reducing COVID-19 disease severity.

(Related media article: Cepon-Robins illustrates how immune responses to intestinal parasites could reduce severity of COVID-19 - Anna Squires, Communique.)

• 2020 Oct 15 Potential Influence of Helminth Molecules on COVID-19 Pathology -- Full text | PDF

Helminth parasites could change the outcome of COVID-19 infections, in areas of the world where helminthic infections are still prevalent, by inducing a modified Th2 response with a controlled inflammatory component. Notably, in countries of Africa and Latin America, where helminth infections are still common, the numbers of reported COVID-19 deaths are substantially lower than those reported in high-income countries.

• 2020 Oct 8 COVID-19 Lethality in Sub-Saharan Africa and Helminth Immune Modulation -- Full text | PDF

… we argue that helminth coinfection… may be related to the low lethality of COVID-19 in Sub-Saharan Africa.

• 2020 Oct Does the hygiene hypothesis apply to COVID-19 susceptibility? -- Full text | PDF

The hygiene hypothesis, which posited that children exposed to certain environments and enteric organisms such as helminths were less likely to develop allergies and autoimmune diseases than those who experienced a more hygienic upbringing, may apply to COVID-19 susceptibility and severity.

• 2020 Aug 17 Helminth coinfection and COVID-19: An alternate hypothesis -- Full text | PDF

We believe… that any interaction between pre-existing helminth infection and the subsequent severity of COVID-19 need not necessarily be a negative one, and theoretical and empirical evidence suggests that helminths may indeed have a mitigating effect.

• 2020 May 28 The global helminth belt and Covid-19: the new eosinophilic link

Our main hypothesis therefore is that chronic helminth infection, and the immune consequences thereof, is the main reason why the Covid-19 pandemic have a relatively much lower presence in the millenarian global helminth belt than in the modern urban "dewormed" world...

• 2020 May 18 Parasites and their protection against COVID-19- Ecology or Immunology? (PDF)

We report a consistent inverse correlation between the incidence of COVID-19 and parasitic infections observed across WHO regions. These preliminary findings from an ecological analysis, support our hypothesis of a possible immune-modulatory mechanism induced by parasitic infections, which is protective against COVID-19 and warrants further investigation.

• 2020 May 1 Will helminth co-infection modulate COVID-19 severity in endemic regions? -- Full text | PDF

We call on the research community to investigate the influence of helminth co-infection on COVID-19 outcomes as the pandemic spreads through the helminth-endemic regions of the word. Potential negative effects may influence recommendations on deworming.

• 2020 Apr 27 Asthma and COVID-19: The Eosinophilic Link

Finally, we could also speculate that the high prevalence of parasitic diseases and therefore the pervasiveness of (blood or tissue) eosinophilia and the relatively low incidence of the (COVID-19) pandemic in areas like Tropical Africa or the Indian subcontinent, could be somehow linked. Only time and further research will tell us if there is a relevant connection here.

The experience of Brazil

Brazil has been one of the countries most severely affected by the pandemic, with SARS-CoV-2 spreading particularly rapidly in the pandemic’s early stages in Maranhao State in the Northeast region of the country. However, this state’s fatality rate peaked in May and fell consistently thereafter. [5]

By April 2021, Maranhao State had Brazil’s lowest covid-19 caseload (9 per 100,000) and almost the lowest death rate (0.61 per 100,000) per population. [6]

Researchers reporting from Maranhao in September 2020 had estimated that the prevalence of detectable antibodies (seroprevalence) in the state was already the highest, and the closest reported at that point, to the herd immunity threshold, [7] in spite of the population’s generally low economic and nutritional status.

Soil-transmitted helminths (STH) are still endemic in Brazil’s Northeast region, [8] and a national survey carried out in 2016 had found the region’s highest STH prevalence was in Maranhao State, which also had the highest hookworm rate in Brazil. [9]

The experience among helminthic therapy self-treaters

So far, there have been very few reports from members of the global community of helminthic therapy self-treaters describing the experience of COVID-19. Most comments from those in this community have described how they began to show signs of what appeared to be a viral infection but which soon resolved, or followed a course very similar to that of a bout of influenza, leaving most of these individuals uncertain as to whether they had had COVID-19 or not. The marked absence from this community of over 60,000 members of reports of severe illness attributed to COVID-19 may, itself, be suggestive of a beneficial role for helminths.

I had a CONFIRMED case of Covid-19 and I am hosting about 15-20 NA. The virus came like a quick storm for me. Day 1, I had a fever of 101-2 degrees all day and severe body aches. Day 2, my fever completely subsided and I've been slowly recovering ever since. I'm not sure if my NA had any role to play. I'm 7 days from onset and still dealing with some fatigue and loss of smell/taste. [10]

I came down with COVID but I wouldn’t consider my aches more severe than I usually get when I’m ill. I’m generally all aches, no fever. I had a lingering odd feeling in my respiratory tract but nothing severe. Also a headache after the first two days, followed by total loss of smell that has still not completely returned. I was never super fatigued but the aches lingered a bit. I only host 5 NA and it’s time to redose. [11]

Treating COVID-19 while hosting helminths

Anyone hosting helminths who does develop this illness will want to use therapies that will not have any detrimental effect on their helminth colony. A comprehensive list of effective, helminth-friendly, natural antiviral therapies can be found here.

The reintroduction to the digestive tract of a controlled number of specially domesticated, mutualistic helminths (intestinal worms) in the form of microscopic eggs or larvae to reconstitute a depleted biome to treat or prevent chronic inflammation, autoimmune disease and other immune-related disorders, including allergy.

An intestinal worm which grows large enough to be seen with the naked eye when mature but which is microscopic when administered in helminthic therapy. Wikipedia:Helminths

An intestinal worm which grows large enough to be seen with the naked eye when mature but which is microscopic when administered in helminthic therapy. Wikipedia:Helminths

A helminth that lives in the small intestine. Necator americanus (NA) is the only hookworm species used in helminthic therapy. Its microscopic larvae are applied periodically to the skin.

An organism that lives in or on another organism (its host) and benefits at the host’s expense. (The organisms used in helminthic therapy are, strictly speaking, not parasites, but mutualists, because they have a mutually beneficial symbiotic relationship with their hosts.)

All the microorganisms living in and on the body, or the genome of these microorganisms. "Microbiota" refers to the specific population of microorganisms living in a certain part of the body, such as the gut. These two terms are often used interchangeably.

An organism that lives in or on another organism (its host) and benefits at the host’s expense. (The organisms used in helminthic therapy are, strictly speaking, not parasites, but mutualists, because they have a mutually beneficial symbiotic relationship with their hosts.)

An intestinal worm which grows large enough to be seen with the naked eye when mature but which is microscopic when administered in helminthic therapy. Wikipedia:Helminths

A helminth that lives in the small intestine. Necator americanus (NA) is the only hookworm species used in helminthic therapy. Its microscopic larvae are applied periodically to the skin.

The reintroduction to the digestive tract of a controlled number of specially domesticated, mutualistic helminths (intestinal worms) in the form of microscopic eggs or larvae to reconstitute a depleted biome to treat or prevent chronic inflammation, autoimmune disease and other immune-related disorders, including allergy.

the human hookworm, Necator americanus