Malaria Endemicity Effect on Incidence and Mortality Rate of COVID-19 in Some Malaria-Endemic Regions of Iran; An Ecological Study (2020-21)

Background: According to recent reports during the COVID-19 pandemic, malaria-endemic regions have a significantly lower COVID-19 case and mortality rate than those malaria-non-endemic.  This study aimed to evaluate the prevalence of COVID-19 in malarious areas of southern Iran and the incidence of disease in people previously infected with malaria. Materials and Methods: We conducted an ecological study during the Covid-19 epidemic period in a malaria-endemic area, Hormozgan province, by including all critically ill patients with Covid-19 admitted to hospitals in different counties. The malaria cases were matched in the Covid patient's list. Also, the cumulative incidence and mortality rate of the Covid-19 were calculated in all counties. Results: The results show that malaria-endemic regions have a lower cumulative incidence and mortality rate than the others. Moreover, it was found that people with a history of malaria were not infected with Covid 19. Conclusion: It seems that malaria endemicity may positively affect the lower incidence and mortality rate of COVID-19 in malaria-endemic regions. However, further studies must be carried out to confirm the hypothesis that malaria reduces the risk of Covid-19 in other parts of the world.