RESUMO
ObjectiveChagas disease (CD) continues to be a major public health burden in Latina America, where co-infection with SARS-CoV-2 can occur. However, information on the interplay between COVID-19 and Chagas disease is lacking. Our aim was to assess clinical characteristics and in-hospital outcomes of patients with CD and COVID-19, and to compare it to non-CD patients. MethodsPatients with COVID-19 diagnosis were selected from the Brazilian COVID-19 Registry, a prospective multicenter cohort, from March to September, 2020. CD diagnosis was based on hospital record at the time of admission. Study data were collected by trained hospital staff using Research Electronic Data Capture (REDCap) tools. Genetic matching for sex, age, hypertension, DM and hospital was performed in a 4:1 ratio. ResultsOf the 7,018 patients who had confirmed infection with SARS-CoV-2 in the registry, 31 patients with CD and 124 matched controls were included. Overall, the median age was 72 (64.-80) years-old and 44.5% were male. At baseline, heart failure (25.8% vs. 9.7%) and atrial fibrillation (29.0% vs. 5.6%) were more frequent in CD patients than in the controls (p<0.05 for both). C-reactive protein levels were lower in CD patients compared with the controls (55.5 [35.7, 85.0] vs. 94.3 [50.7, 167.5] mg/dL). Seventy-two (46.5%) patients required admission to the intensive care unit. In-hospital management, outcomes and complications were similar between the groups. ConclusionsIn this large Brazilian COVID-19 Registry, CD patients had a higher prevalence of atrial fibrillation and chronic heart failure compared with non-CD controls, with no differences in-hospital outcomes. The lower C-reactive protein levels in CD patients require further investigation. Key messagesO_ST_ABSWhat is already known about this subject?C_ST_ABSO_LIPreexisting cardiovascular disease enhances vulnerability to COVID-19. C_LIO_LICo-infection with SARS-CoV-2 and T.cruzi can occur in patients living in areas in which both infections are epidemic. C_LI What does this study add?O_LIDespite a higher frequency of chronic heart failure and atrial fibrillation, our findings do not suggest that co-infection with T.cruzi and SARS-CoV-2 worsens in-hospital outcomes. C_LIO_LIChagas disease patients were observed to have lower C-reactive protein (CRP) levels. C_LI How might this impact on clinical practice?O_LIGiven the current circulation of SARS-CoV-2 at high levels and millions of T cruzi-infected individuals living in Brazil, the risk for co-infections substantially increases. C_LIO_LIFurther studies are needed to investigate why CRP levels were lower in CD patients. We hypothesized that CD patients might have a lower risk of unregulated inflammatory response to COVID-19, as they already have an active chronic inflammatory and immune response response triggered by T.cruzi infection. C_LI
