Helminthic therapy and COVID-19

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Helminths may confer protection against COVID-19[edit]

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[edit]

This study showed a significant inverse correlation between the presence of intestinal parasites and COVID-19 severity, suggesting that parasite co-infection, with both protozoa and helminths, may protect against progression to severe COVID-19.
A growing body of studies suggests COVID-19 emulates many aspects of systemic autoimmune disorders, including the release of a flurry of overactive immune cells that produce toxic webs of proteins and DNA called neutrophil extracellular traps, or NETs.
Therapeutic administration of helminth excretory/secretory factors has been shown to modulate these neutrophil responses, abolishing NET formation and reducing the ensuing inflammation. [5]
This study demonstrated that hospitalized patients with moderate and severe COVID-19 have microbial signatures of gut dysbiosis. Since helminths are known to engender beneficial changes in the gut microbiota [6] this study’s findings may suggest a beneficial role for helminths in reducing COVID-19 severity.
The number of SARS-CoV-2 cases was not the only predictor of deaths, with countries with a high prevalence of hookworm and malaria experiencing fewer SARS-CoV-2 deaths compared to those with lower hookworm and malaria prevalence.
The present review focused on the epidemiology of SARS-CoV-2, helminths and fine particulate matter air pollution exposure in helminth endemic regions, the possible immunomodulatory activity of helminths against SARS-CoV-2 hyper-inflammatory immune response, and whether air and water pollutants can further exacerbate SARS-CoV-2 related cytokine storm and in the process hinder helminths immunomodulatory functionality.
Reviews current knowledge about the relationships between a wide range of parasitic infections and COVID-19.
The implications of the immunomodulation effect of helminths in endemic areas must be considered in the context of COVID-19 mass vaccination.
It is essential to remember the manifold negative effects of intestinal parasitosis... In regions where undernutrition rather than overnutrition is a dominating concern, nutritional and metabolic compromise may present a greater hazard in persons at risk for SARS-CoV-2 infection.
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.
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.
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)
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.)
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.
… we argue that helminth coinfection… may be related to the low lethality of COVID-19 in Sub-Saharan Africa.
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.
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.
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...
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.
Explores the possible factors, including parasites, that may be contributing to the lower number of COVID-19 deaths reported in Africa.
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.
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[edit]

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. [8]

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. [9]

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, [10] in spite of the population’s generally low economic and nutritional status.

Soil-transmitted helminths (STH) are still endemic in Brazil’s Northeast region, [11] 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. [12]

The experience among helminthic therapy self-treaters[edit]

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. [13]
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. [14]

Treating COVID-19 while hosting helminths[edit]

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.

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