The role of the oxidative stress-inflammation axis in the COVID-19-infected patients with chagas disease: a key parameter to be considered during the pandemic

Abstract

Purpose of ReviewThe global COVID-19 pandemic has become a major public health problem since December 2019, affecting millions of people, especially individuals with comorbidities including cancer, diabetes, hypertension, cardiovascular disease, obesity, and hematological disorders. People are still infected and die despite vaccination since the virus mutates quickly. Enzyme deficiencies, neglected conditions, and arboviral infections are currently discussed as potential contributors to COVID-19 vulnerability. Chagas disease (CD) is caused by the protozoan parasite Trypanosoma cruzi, affecting 6-8 million people worldwide, and CD is endemic in most of Latin America. Since people with CD have been found in the USA, Canada, Japan, and Europe because of the increased immigration, the spread and implications of CD have drawn attention since the disease shares similar pathogenesis with COVID-19.Recent FindingsEnhanced oxidative stress and inflammation are the common features of CD and COVID-19 infection, leading to thrombosis, cardiomyopathy, thrombosis, cytokine storm, and heart failure associated with mortality and disease severity; therefore, it is still debated whether COVID-19 activates CD disease. On the other hand, CD patients can be more vulnerable to COVID-19 and show severe symptoms during the acute or chronic phase. Inflammation and oxidative stress are the first responses to COVID-19 or T. cruzi infections, where the vicious cycle between them is the key to infection pathogenesis. Therefore, this review discussed the importance of the oxidative stress-inflammation axis in disease pathogenesis, including thrombosis, immune response, cardiomyopathy, and heart failure. Additionally, antioxidant and anticoagulant therapies showed promising outcomes in the CD and COVID-19 patients addressing the importance of the oxidative stress-inflammation axis on the disease pathogenesis.CD patients can be considered and treated as a risk group for COVID-19 infection even if the disease is in the silent phase to prevent mortality and severe symptoms. Antioxidant therapy should be considered a supportive treatment in CD patients infected with COVID-19.