Enhancing screening adherence for strongyloides infection in latinx inpatients with COVID-19: a local protocol implementation study

ABSTRACT

Strongyloides stercoralis hyperinfection syndrome has been observed in immunosuppressed coronavirus disease 2019 (COVID-19) patients. Detecting and treating asymptomatic Strongyloides infection in individuals from endemic areas can effectively prevent hyperinfection. Unfortunately, many clinicians are unaware of this neglected infection. Therefore, we aimed to evaluate whether including Strongyloides screening in COVID-19 management protocols would encourage this practice. To accomplish this, we conducted a retrospective single-center study at ‘Hospital Universitario 12 de Octubre’ in Madrid, Spain, comparing two consecutive cohorts. The first cohort comprised all Latinx patients over 18 years old who were admitted for COVID-19 between March 1^st and April 30^th, 2020. The second cohort consisted of Latinx patients admitted between July 1^st and December 31^st, 2020, following an amendment to the COVID-19 management protocol that recommended screening for strongyloidiasis in at-risk patients. We identified 559 and 795 patients in the first and second periods, respectively. The percentage of individuals screened increased significantly from 8.8% to 51.6% after the screening recommendation was included in the protocol (odds ratio [OR] 11.08, 95% confidence interval [CI] 8.01–15.33). In both periods, the screening rate was significantly higher among those receiving immunosuppression than those who did not receive steroids and/or tocilizumab. No other factors influenced the screening rate. In conclusion, including strongyloidiasis screening recommendations in COVID-19 management protocols led to its increased implementation. However, the overall screening rate remained low, emphasizing the need for further efforts to enhance screening practices.

KEYWORDS:

• Strongyloides stercoralis
• Coronavirus disease 2019 (COVID-19)
• screening
• Latinx population
• immigrants

Acknowledgements

The authors would like to acknowledge all the healthcare workers involved in the response to the COVID-19 pandemic in the hospital and, singularly, those who suffered from COVID-19.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This work was supported by Instituto de Salud Carlos III, Ministry of Science and Innovation, Spain (COVID-19 call COV20/00181) — co-financed by the European Development Regional Fund A Way to achieve Europe. IL is supported by “Centro de Excelencia Severo Ochoa 2019-2023” Program (CEX2018-000806-S), from the Spanish Ministry of Science and Innovation and State Research Agency.