Acute respiratory distress syndrome in Plasmodium vivax malaria. A case-control study of comparison between ARDS and non-ARDS patients in P. Vivax malaria
DOI:
https://doi.org/10.18203/2320-6012.ijrms20232425Keywords:
Acute respiratory distress syndrome, Complicated malaria, India, MalariaAbstract
Background: Plasmodium vivax was conventionally considered to be a benign parasite for centuries but in the recent years have proved to be a virulent parasite causing severe malaria. Acute respiratory distress syndrome (ARDS) is one of such severe complications with a significant morbidity and mortality. The objective of this study was to find the prevalence of ARDS and identify the associated factors that could potentially lead to ARDS in patients with vivax malaria.
Methods: A retrospective case-control study was conducted at a tertiary hospital in New Delhi. 329 patients with an established diagnosis of Plasmodium vivax mono-infection were identified using hospital medical records, the associated factors were evaluated and compared to calculate the odds of developing ARDS. All patients were categorized into ARDS cases and non-ARDS controls.
Results: The incidence of ARDS was 7% with a female sex predominance (60.86%). Mean urea (71.5 mg/dl), creatinine (2.7 mg/dl), and AST (97.8 units/l) elevation in addition to decreased hemoglobin (7.7 gm/dl) and platelets count (38,217 cells/µl) proved to be significantly associated with ARDS in our study.
Conclusions: Plasmodium vivax is a virulent parasite and can cause severe malaria even in the setting of isolated infection. Cytokine mediated diffuse inflammatory response is a postulated pathophysiology causing ARDS.
References
Malaria. Centers for disease control and prevention. Available at: https://www.cdc.gov/parasites/malaria/. Accessed on 2 February 2023.
World Health Organization, world malaria report 2021. Available at: https://reliefweb.int/report/world/world-malaria-report-2021. Accessed on 2 February 2023.
Val F, Avalos S, Gomes AA, Zerpa JE, Fontecha G, Siqueira AM, et al. Are respiratory complications of Plasmodium vivax malaria an underestimated problem? Malaria J. 2017;16:1-6.
Siqueira AM, Lacerda MV, Magalhães BM, Mourão MP, Melo GC, Alexandre MA, et al. Characterization of Plasmodium vivax-associated admissions to reference hospitals in Brazil and India. BMC Med. 2015;13:1-5.
Val F, Machado K, Barbosa L, Salinas JL, Siqueira AM, Alecrim MG, et al. Respiratory complications of Plasmodium vivax malaria: systematic review and meta-analysis. Am J Trop Med Hyg. 2017;97(3):733.
Harman E, Riley L. Acute respiratory distress syndrome. Crit Care. 2020:e165139.
Anstey NM, Russell B, Yeo TW, Price RN. The pathophysiology of vivax malaria. Trends Parasitol. 2009;25(5):220-7.
Matlani M, Kojom LP, Mishra N, Dogra V, Singh V. Severe vivax malaria trends in the last two years: a study from a tertiary care centre, Delhi, India. Ann Clin Microbiol Antimicrobiol. 2020;19:1-1.
Singh SP, Singh R, Ahmad N. Complications of vivax malaria in Uttarakhand, India. Int J Res Med Sci. 2013;1(4): 532-5.
Rahimi BA, Thakkinstian A, White NJ, Sirivichayakul C, Dondorp AM, Chokejindachai W. Severe vivax malaria: a systematic review and meta-analysis of clinical studies since 1900. Malar J. 2014;13:1-0.
Moody A. Rapid diagnostic tests for malaria parasites. Clin Microbiol Rev. 2002;15:66-78.
Saguil A, Fargo M. Acute respiratory distress syndrome: diagnosis and management. Am Fam Physician. 2020;101(12):730-8.
Tan LK, Yacoub S, Scott S, Bhagani S, Jacobs M. Acute lung injury and other serious complications of Plasmodium vivax malaria. Lancet Infect Dis. 2008;8(7):449-54.
Batchelor JD, Malpede BM, Omattage NS, DeKoster GT, Henzler-Wildman KA, Tolia NH. Red blood cell invasion by Plasmodium vivax: structural basis for DBP engagement of DARC. PLoS Path. 2014;10(1):e1003869.
Rogerson SJ, Hviid L, Duffy PE. Malaria in pregnancy: pathogenesis and immunity. Lancet Infect Dis. 2007;7(2):105-17.
Traoré B, Muanza K, Looareesuwan S, et al. Cytoadherence characteristics of Plasmodium falciparum isolates in Thailand using an in vitro human lung endothelial cells model. Am J Trop Med Hyg. 2000;62(1):38-44.
Robert C, Pouvelle B, Meyer P, Muanza K, Fujioka H, Aikawa M, Scherf A, Gysin J. Chondroitin-4-sulphate (proteoglycan) a receptor for Plasmodium falciparum-infected erythrocyte adherence on brain microvascular endothelial cells. Res Immunol. 1995;146(6):383-93.
Karunaweera N, Wanasekara D, Chandrasekharan V, Mendis K, Carter R. Plasmodium vivax: paroxysm-associated lipids mediate leukocyte aggregation. Malar J. 2007:1-4.
Karunaweera ND, Wijesekera SK, Wanasekera D, et al. The paroxysm of Plasmodium vivax malaria. Trends Parasitol. 2003;19(4):188-93.
Bruetsch W. The histopathology of therapeutic (tertian) malaria. Am J Psychiatr. 1932;89(1):19-65.
Anstey NM, Handojo T, Pain MC, Kenangalem E, Tjitra E, Price RN, et al. Lung injury in vivax malaria: pathophysiological evidence for pulmonary vascular sequestration and posttreatment alveolar-capillary inflammation. J Infect Dis. 2007 Feb 15;195(4):589-96.
Maguire GP, Handojo T, Pain MC, Kenangalem E, Price RN, Tjitra E, et al. Lung injury in uncomplicated and severe falciparum malaria: a longitudinal study in Papua, Indonesia. J Infect Dis. 2005;192(11):1966-74.
Handayani S, Chiu DT, Tjitra E, Kuo JS, Lampah D, Kenangalem E, et al. High deformability of Plasmodium vivax-infected red blood cells under microfluidic conditions. J Infect Dis. 2009;199(3):445-50.
Douglas NM, Anstey NM, Buffet PA, Poespoprodjo JR, Yeo TW, White NJ, et al. The anaemia of Plasmodium vivax malaria. Malar J. 2012;11:1-4.
Suratt BT, Parsons PE. Mechanisms of acute lung injury/acute respiratory distress syndrome. Clin Chest Med. 2006;27(4):579-89.
Lacerda MV, Mourão MP, Coelho HC, Santos JB. Thrombocytopenia in malaria: who cares? Memor Inst Oswaldo Cruz. 2011;106:52-63.
Coelho HC, Lopes SC, Pimentel JP, Nogueira PA, Costa FT, Siqueira AM, et al. Thrombocytopenia in Plasmodium vivax malaria is related to platelets phagocytosis. PLoS One. 2013;8(5):e63410.
Raza A, Ghanchi NK, Sarwar Zubairi AB, Raheem A, Nizami S, Beg MA. Tumor necrosis factor-α, interleukin-10, intercellular and vascular adhesion molecules are possible biomarkers of disease severity in complicated Plasmodium vivax isolates from Pakistan. PloS One. 2013;8(12):e81363.
Maknitikul S, Luplertlop N, Grau GE, Ampawong S. Dysregulation of pulmonary endothelial protein C receptor and thrombomodulin in severe falciparum malaria-associated ARDS relevant to hemozoin. PLoS One. 2017;12(7):e0181674.
Deroost K, Tyberghein A, Lays N, Noppen S, Schwarzer E, Vanstreels E, et al. Hemozoin induces lung inflammation and correlates with malaria-associated acute respiratory distress syndrome. Am J Respir Cell Mol Biol. 2013;48(5):589-600.
