BCG vaccination policy and preventive chloroquine usage: do they have an impact on COVID-19 pandemic?
BCG vaccination policy and preventive chloroquine usage: do they have an impact on COVID-19 pandemic?
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DOI：
10.1038/s41419-020-2720-9
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发表时间：
2020-07-08
影响因子：
9
通讯作者：
Das, Gobardhan
中科院分区：
文献类型：
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作者：
Sharma, Abhibhav;Sharma, Saurabh Kumar;Das, Gobardhan
2019冠状病毒病（COVID-19）是由冠状病毒2（SARS-CoV-2）引起的严重急性呼吸道综合征。鉴于其在全球迅速蔓延，世界卫生组织已于二零二零年三月十一日宣布其为大流行病。有趣的是，该疾病的全球传播并不均匀，但迄今为止，一些国家受到的影响相对较小。这种异常行为的原因尚未完全了解，但已经提出了不同的假设。在这里，我们讨论其中两个的可行性：卡介苗（BCG）的普遍接种和抗疟药氯喹（CQ）的广泛使用。最近的文献对这两个问题进行了充分的讨论，得出了肯定和否定的结论：我们认为，全面介绍关于这两个问题的现有数据将是有益的。对报告COVID-19病例超过1000例的国家的数据分析显示，与普遍接种疫苗的国家相比，没有接种BCG疫苗或已停止接种BCG疫苗的国家的发病率和死亡率较高。我们对CQ的可用数据进行了类似的分析，CQ是非洲大陆和其他疟疾流行国家广泛使用的药物;我们在这里讨论它，因为CQ已被用作治疗COVID-19患者的药物。由于对疟原虫的抗药性的发展，一些非洲国家不再正式推荐它用于对抗疟疾，但它在整个非洲大陆的使用仍然很分散。综上所述，文献中的数据表明卡介苗免疫与COVID-19疾病的发病率和严重程度之间可能存在负相关。
Coronavirus disease 2019 (COVID-19) is a severe acute respiratory syndrome caused by Coronavirus 2 (SARS-CoV-2). In the light of its rapid global spreading, on 11 March 2020, the World Health Organization has declared it a pandemic. Interestingly, the global spreading of the disease is not uniform, but has so far left some countries relatively less affected. The reason(s) for this anomalous behavior are not fully understood, but distinct hypotheses have been proposed. Here we discuss the plausibility of two of them: the universal vaccination with Bacillus Calmette-Guerin (BCG) and the widespread use of the antimalarial drug chloroquine (CQ). Both have been amply discussed in the recent literature with positive and negative conclusions: we felt that a comprehensive presentation of the data available on them would be useful. The analysis of data for countries with over 1000 reported COVID-19 cases has shown that the incidence and mortality were higher in countries in which BCG vaccination is either absent or has been discontinued, as compared with the countries with universal vaccination. We have performed a similar analysis of the data available for CQ, a widely used drug in the African continent and in other countries in which malaria is endemic; we discuss it here because CQ has been used as the drug to treat COVID-19 patients. Several African countries no longer recommend it officially for the fight against malaria, due to the development of resistance to Plasmodium, but its use across the continent is still diffuse. Taken together, the data in the literature have led to the suggestion of a possible inverse correlation between BCG immunization and COVID-19 disease incidence and severity.