Markedly Lower Rates of Coronavirus Infection and Fatality in Malaria-Endemic Regions

5/5 Pre-Exposure Prophylaxis study (treated before exposed to the virus)

Mitchell et al., SSRN, doi:10.2139/ssrn.3586954 (Preprint)
Markedly Lower Rates of Coronavirus Infection and Fatality in Malaria-Endemic Regions – A Clue As to Treatment?

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Analysis of COVID-19 amongst 2.4B people shows a wide counterintuitive disparity between well-developed and less-developed countries, with more affluent countries about one hundred times more likely to be infected and die due to COVID-19. They find the effect is most apparent when comparing to countries with the highest rates of endemic malaria. Since travelers to malaria-endemic countries are likely to be taking antimalarial prophylaxis and there is evidence of efficacy with COVID-19, authors find the data highly probative for the hypothesis that prophylactic antimalarial use by incoming visitors markedly attenuates a country’s COVID-19 fatality rate. While authors do not adjust for age differences, those adjustments can only account for a small fraction of the observed difference.

Mitchell et al., 5/5/2020, retrospective, multiple countries, multiple regions, preprint, 2 authors.

risk of death, 99.0% lower, RR 0.01, p < 0.001.

This study is excluded in meta analysis: excessive unadjusted differences between groups.

Effect extraction follows pre-specified rules prioritizing more serious outcomes. For an individual study the most serious outcome may have a smaller number of events and lower statistical signficance, however this provides the strongest evidence for the most serious outcomes when combining the results of many trials.

All 344 studies Meta Analysis

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