Has Malaria developed immunity against Covid-19?

Nazia Kanwal and Amer Jamil

Corresponding author: amerjamil@yahoo.com

Novel covid-19 has spread throughout the globe in few weeks 1. To compare statistics of
COVID-19 infected people from different countries (Fig 1a), as the globe is divided into five
zones ranging from 0-49 to 1000+ covid-19 infected cases per million people. The regions with
minimum number of cases have two zones with minimum cases per million and are highlighted
as X and Y regions (Fig. 1a).
Another map, representing countries with highest malarial infections are represented by red color
(Fig. 1b). These countries are divided into three zones viz X’, Y’ and Z’. On comparing the maps
it was found that malarial rich countries (X’ and Y’) have a smaller number of covid-19 infected
people (X and Y). In contrast high infection rates of covid-19 are found to happen in countries
with no malaria. Hence it is speculated that; “Malaria might help in the development of
resistance against Covid-19”. To test this hypothesis we compared incidence of COVID-19 as
percentage of mortality in malarial affected countries with the malaria-free countries.
 Y

Fig. 1a. Map showing cases of COVID-19 all over the globe. Countries depending upon
number of cases of COVID-19 per million population categorized into five different zones.
Light to dark blue shades used to differentiate between countries with low to high number
of COVID-19 cases/million population. Two regions with minimum number of COVID-19
cases are labelled with X and Y.
 Y’

X’
Z’

Fig. 1b. Countries with indigenous cases of malaria. Countries shaded red have indigenous
malaria cases and labelled as X’, Y’ and Z’. (Taken from WHO 2018 report2).
Contraction, Immunity and Mortality in context to Covid-19:
Covid-19 virus infects by injecting single stranded positive sense RNA molecule inside the
human cell. Virus binds with the Angiotensin Converting Enzyme II receptors present on the
human cell membranes of lungs and brain and then translocated inside the cell 3-5. The single
stranded RNA molecule of the virus is a large genome, consisting of six open reading frames.
Large peptide is fragmented with viral encoded protease and two other proteases into sixteen
non-structural proteins and four structural membrane proteins. The viral proteins are translated
and packed in cellular endoplasmic reticulum and Golgi bodies 6. On the other hand, host cell
takes virus as foreign particle and activates immune system to rip viral RNA molecule apart. A
battle starts between host cell defense and the virus for conquering host cell. Initially infected
cell signals to nearby cells by displaying Major Histocompatibility complex (MHC) proteins on
the cell surface with pieces of viral proteins. The message is read by circulating T-cells which
release cytotoxic factors to kill infected cells 7. If virus succeeds and gets control on host cell’s
defense, it inhibits the movement of MHC proteins on the membranes, and produces structural
and non-structural viral proteins and multiply exponentially, killing the cell and ready to infect
other cells (Laing K. https://www.immunology.org/public-information/bitesized-immunology/
pathogens-and-disease/immune-responses-viruses.). Host cell produces other immune cells,
called natural killer (NK) cells; these cells attack on those cells having less number of HMC
protein than usual – to control viral infection. Once inside infected cells, NK cells produce
cytotoxic factors and cytokines release from infected cells to speed-up killing process of nearby
cells. These cytokines include interferons and tumor necrosis factors 8.
The immunity works by memorizing way of defense to control viral infection in future by
producing particular antibodies. This immunity gives strength to fight off the virus. But, if
host’s immunity is not strong enough to control viral replication, the person will be infected
due to uncontrolled viral replication followed by and virus-induced cell death by host cells.
Percent mortality calculated as percentage of deaths as compared to total infected persons.
High rate of mortality means less immunity against covid-19. In malaria-affected countries,
percentage mortality has been found very low as compared to mortality in malaria-free countries
(Fig. 3a and b). For example, percentage mortality due to COVID-19 in Mexico, Ecuador,
Germany, Brazil and Iran was found to be 12, 8 and 5%. In contrast, the percentage mortality
was 18% in France, 16% in Belgium, 15% in Italy, and 14% in UK. This significant difference
might be due to the increased immunity among people of malarial countries
(https://www.drroyspencer.com/2020/03/some-covid-19-vs-malaria-numbers-countries-with-malaria-
have-virtually-no-coronavirus-cases-reported/ ).

Conclusion: The comparison strengthens the idea that the malaria has brought some kind
of resistance against COVID-19 infection. However, experimental studies are required to
understand that why malarial countries exhibit significant resistance against Covid-19?
What are the different factors contributed in this resistance? If we get answer to these
questions then we might be able to develop effective therapies against Covid-19.

Comparison of %age of mortality between Malarial and Non-malarial countries

having 0.01 to 0.1 million Covid-19 cases
16%

14%

12%

10%

8%

6%

4%

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 Comparison of percentge of expected Covid+ people between Malarial and Non-
malarial countries having 0.01 to 0.1 million of Covid-19 cases

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Comparison of %age of mortality between Malarial

and Non-malarial countries 0.1 to 0.2 million Covid-
19 cases

18%
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Germany France Canada
Laing K. Immune Response to viruses. Pathogens and Disease
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