Background. Though most people with COVID-19 disease show asymptomatic to mild illness, a substantial number of patients are at high risk of developing severe disease and adverse outcomes with long COVID-19 and death. Even though some studies showed that previously existing infections with parasites amend the host’s body defenses to increase resistance to infection with SARS-CoV-2, there is limited data in Ethiopia. Objectives. This study is aimed at determining the COVID-19 disease severity and its association with intestinal parasite coinfection and urine biochemical parameters among COVID-19-confirmed patients admitted at Debre Markos University COVID-19 Center, 2021. Methods. A prospective cohort study was conducted on 136 RT-qPCR-confirmed COVID-19 patients admitted at Debre Markos University COVID-19 Center from January 1 to March 30, 2021. Sociodemographic and clinical data were collected by using standardized data collection forms. A urine biochemical test was performed using a dry urine dipstick kit and stool examination using direct wet mount microscopic examination and formalin-ether concentration method. The chi-square test, Fisher exact test, and ordinal logistic regression analysis were computed to assess association with outcome variables using Statistical Package for Social Science software (version 24). Result. A total of 136 COVID-19-confirmed patients participated in this study. The median age of the participants was 48 years. The majority (86 (62.5%)) of them were male in sex. Of the 136 cases, 39 (28.7%) had died. Among the 136 patients, 22 (16.2%) were coinfected with intestinal parasites. COVID-19 patients who have intestinal parasite coinfection had lower odds of developing clinically severe COVID-19 compared to noninfected (; 95% ; ). The majority (104 (76.5%)) of them have abnormal urine biochemical results. From the abnormal urine biochemical tests observed, the urine blood, glucose, and ketone tests were positive for 54 (39.7%), 36 (26.5%), and 30 (21.1%) patients, respectively. Among the 31 critical COVID-19 patients, 25 (80.6%) showed abnormal urine biochemical parameters. Age and comorbidity were significantly associated with COVID-19 severity (). Conclusion. Patients with old age and comorbidity had an increased risk of developing severe COVID-19 disease. Patients having SARS-CoV-2 and intestinal parasitic coinfections demonstrated mild COVID-19 disease severity. Abnormal urine biochemical results were common among critical COVID-19 patients. Thus, advanced study on the effect of the interaction among intestinal parasites on COVID-19 clinical severity and its mechanisms is essential.

中文翻译：

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埃塞俄比亚西北部德布雷马科斯大学 COVID-19 中心收治的 COVID-19 确诊患者中，COVID-19 严重程度及其与肠道寄生虫混合感染和尿液生化参数的关系

背景。尽管大多数患有 COVID-19 疾病的人表现出无症状甚至轻度疾病，但相当多的患者面临着发展为严重疾病以及长期感染 COVID-19 和死亡的不良后果的高风险。尽管一些研究表明，先前存在的寄生虫感染可以改善宿主的身体防御能力，从而增强对 SARS-CoV-2 感染的抵抗力，但埃塞俄比亚的数据有限。目标。本研究旨在确定 2021 年德布雷马科斯大学 COVID-19 中心收治的 COVID-19 确诊患者的 COVID-19 疾病严重程度及其与肠道寄生虫合并感染和尿液生化参数的关系。对 2021 年 1 月 1 日至 3 月 30 日在德布雷马科斯大学 COVID-19 中心收治的 136 名经 RT-qPCR 确诊的 COVID-19 患者进行了一项前瞻性队列研究。通过使用标准化数据收集表格收集社会人口学和临床数据。使用干尿试纸套件进行尿液生化测试，并使用直接湿涂片显微镜检查和福尔马林乙醚浓缩法进行粪便检查。使用社会科学统计软件包（版本 24）计算卡方检验、Fisher 精确检验和序数逻辑回归分析，以评估与结果变量的关联。结果。共有 136 名 COVID-19 确诊患者参与了这项研究。参与者的平均年龄为 48 岁。其中大多数（86 名（62.5%））是男性。136 例病例中，39 例（28.7%）死亡。136例患者中，22例（16.2%）同时感染肠道寄生虫。与未感染的患者相比，肠道寄生虫合并感染的 COVID-19 患者发展为临床重症 COVID-19 的几率较低（; 95%; ）。其中大多数（104 名（76.5%））尿液生化结果异常。从观察到的异常尿液生化检测结果来看，尿血、血糖和酮检测阳性的患者分别为54例（39.7%）、36例（26.5%）和30例（21.1%）。31例危重COVID-19患者中，25例（80.6%）尿液生化参数异常。年龄和合并症与 COVID-19 的严重程度显着相关（）。 结论。老年且患有合并症的患者患严重 COVID-19 疾病的风险增加。患有 SARS-CoV-2 和肠道寄生虫双重感染的患者表现出轻微的 COVID-19 疾病严重程度。尿液生化结果异常在重症 COVID-19 患者中很常见。因此，深入研究肠道寄生虫之间的相互作用对 COVID-19 临床严重程度及其机制的影响至关重要。