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COVID-19 in a Patient with Visceral Leishmaniasis

Antonio Marco Miotti, Aria Patacca, Carmela Grosso and Francesco Cristini

Visceral Leishmaniasis is an infectious disease caused by protozoans of Leishmania genus and transmitted by the bite of infected sand flies. Its course is fatal in the absence of appropriate treatment.

Coronavirus disease 2019 (COVID-19) is a respiratory tract infection, first detected in Wuhan, China, in December 2019 and subsequently spread worldwide as a pandemic. It is caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). In its most severe forms, it proves to be life threatening.

Hereby we report, to the best of our knowledge, the first case of COVID-19 in a patient with Visceral Leishmaniasis. He was a 79-year-old Italian male seeking medical attention because of sub-chronic fever associated with asthenia, lack of appetite, weight loss and pancytopenia. After a series of routine tests, the man underwent a bone marrow biopsy, which led to the diagnosis of Visceral Leishmaniasis. He was thus given liposomal amphotericin B, with moderate improvement of clinical conditions and laboratory exams. However, the hospital stay was complicated by COVID-19, since the patient tested positive for SARS-CoV-2 and developed severe interstitial pneumonia, thrombosis of the pulmonary vessels and possible alevolar hemorrhage. Due to multiple comorbidities, the options for Coronavirus treatment were extremely limited and death followed.