Q&A COVID-19 and Chagas Disease

24 March 2020

Below are some general considerations regarding COVID-19 for people with Chagas disease. Each person’s situation may differ and therefore we urge everyone to follow local and national health recommendations as well as their doctor’s advice. COVID-19 is a relatively very new health challenge and we have not enough evidences of how it can interact with other infections. However, there are some good measures to protect ourselves from the COVID-19.

What are the symptoms of COVID-19? Are they different for a Chagas disease patient?

According to the WHO, the most common symptoms of COVID-19, may include fever, dry cough, headache, shortness of breath, fatigue or sore throat. Some patients may have aches and pains, sputum/phlegm production nasal congestion, runny nose, sore throat or even diarrhea. These symptoms are usually mild and begin gradually. 


Some people become infected but they don’t develop any symptoms and don't feel unwell. Most people (about 80%) recover from the disease without needing special treatment. More serious cases develop difficulty breathing. 


The elderly individuals or people with weakened immune systems or underlying conditions like high blood pressure, heart problems or diabetes, are more likely to develop serious illness. People with fever, cough and difficulty breathing should seek medical attention.


COVID-19 is a new virus and we are unsure how it interact with Chagas as we lack the enough scientific evidence. For sure, those who already have severe heart conditions caused by Chagas disease, or a weaker immune system are at higher risk of severe symptoms from COVID-19



If I am chronic patient of Chagas disease without severe complications, am I more vulnerable to COVID-19?


If you only have a positive test of Chagas disease without any additional disease, or complications nor conditions as described above, currently, it is thought that you are not more vulnerable than the general population. 


However, If you have a positive test of Chagas disease and you have serious complications such as heart disease, high blood pressure, heart problems or diabetes, or immune suppression, you are at a higher risk of being seriously affected by COVID-19.



If I am in the acute phase of Chagas disease, and have symptoms of COVID-19, what should I do?


You should contact your healthcare provider, explain that you have acute Chagas disease and are experiencing symptoms of COVID-19, and request testing for COVID-19.


If you have acute (recently acquired) Chagas disease, you should seek antiparasitic treatment for Chagas disease as soon as possible as this provides a better chance of eliminating the infection. 


In addition, it is important to note that if you are experiencing symptoms such as fever, coughing, or sore throat, it does not necessarily mean you have COVID-19. These symptoms could be caused by several other common viral illnesses. 


There is currently no antiviral treatment for mild COVID-19. Treatment of symptoms (for example paracetamol for fever) and self-quarantining is recommended.



Do I need to interrupt the treatment for Chagas disease if I have symptoms or I am positive for COVID-19?


This decision should be made in consultation with your doctor. In general, antiparasitic treatment for chronic Chagas disease could be delayed a few weeks until the COVID-19 infection is treated per national guidelines and/or resolved,


However, there could be special cases, such as acute infections, where doctors determine if it is advisable to continue antiparasitic treatment. 


Because COVID-19 is a relatively new disease, we still do not understand well what the impact of antiparasitic treatment for Chagas disease would be in persons who have COVID-19. 



What should I do if I am Chagas positive without specific treatment and have symptoms of COVID -19?


If you are experiencing COVID-19 symptoms, you should contact your healthcare provider, explain that you have Chagas disease, and describe your potential COVID-19 symptoms to determine if you should be tested. Depending on your test result, your healthcare provider will recommend treatment options. 



What should I do to protect my family myself and from COVID-19 if I am positive for Chagas Disease?


For all people, with or without Chagas disease, social distancing is recommended as a way of slowing the spread of the virus. This means limiting interaction with other people outside the home to the absolute minimum needed to perform essential errands like buying groceries. It is particularly important to minimize contact with family members who are elderly or have underlying health conditions. If you have been in contact with someone who has COVID-19, it is recommended that you practice self-quarantine for 14 days. Different countries have different recommendations in place, so be sure to consult your relevant local and national guidelines.  



If I have cardiologic or digestive complications caused by Chagas Disease, what do I need to do to protect myself from COVID-19?


These conditions could elevate your risk of severe symptoms from COVID-19, and it is recommended to follow the recommendations for high-risk groups, especially social isolation. 



Should I continue attending the health center to continue my Chagas disease treatment during the COVID-19 emergency?


This depends on your individual situation and you should consult with your health care provider, especially if you have cardiac or other complications caused by Chagas Disease.


An acute form of Chagas disease (from recent infection or reactivation) may require more immediate treatment.


If you have no symptoms, you may be able to postpone your treatment. 

We recommend to contact and consult your health center by telephone if possible, in order to reduce the infection’s risk and to let Health structures to manage with the emergency of the COVID-19.



If I am positive for COVID-19 and have Chagas disease, what are the treatments I should not take?


In this case you should remain in contact with your healthcare provider and follow their recommendations. 



If I am pregnant and I suspect of having Chagas disease, am I more vulnerable to COVID-19?


Pregnancy means a risk for having a weaker immune system, which make the body more vulnerable. However, the scientific data is very limited and, at this moment, we have no evidence to define if pregnant women are at a higher risk than the general population until we collect more scientific data.


If you are pregnant and suspect or have the risk of the infection of Chagas disease, you should put in contact with your health provider to be tested as soon as possible.



If I am pregnant and positive for COVID-19 and Chagas disease, what should I do?


First, you should inform your healthcare provider of your Chagas disease diagnosis. In this case, the priority is to protect yourself from the COVID-19 with the recommendations described above. In any case, during pregnancy you will not receive treatment for Chagas disease.


Once you deliver your baby she/he should be tested for Chagas disease at birth and in follow-visits up to 12 months of age. In most cases, treatment of Chagas disease can wait until the COVID-19 infection resolves and after the infant is no longer breastfeeding. There may be situations where treatment would be offered sooner (such as if the Chagas disease infection is very recent or acute).


For COVID-19 treatment should follow local and national recommendations and your physician’s judgment.  


Note: This information has been developed by a group of experts from different organizations of the Chagas Coalition, and in alignment with the information shared by experts of WHO and PAHO. As soon as new scientific data arrives or protocols and guidelines are updated, we will review and adapt the recommendations. We hope this info could be useful for health care professionals and people affected by Chagas disease during this pandemic.