Table 1.

comparison of Clinical presentations and pathophysiology of severe disease in COVID-19 and Malaria

		COVID-19	Malaria
Symptoms	Possible	Asymptomatic, Pre-symptomatic, mild to critical, rapid progression to severe disease	Asymptomatic, mild to critical, rapid progression to severe disease
	Commonly	Flu-like symptoms fever, headache, chills, myalgia, vomiting; diarrhea and cough (commoner in children for malaria)
	Severe/Critical	Trouble breathing		Dehydration from excessive vomiting, severe anemia, prostration, convulsion, coma (unconsciousness), hyperbilirubinemia in liver injury, pulmonary complications that can lead to Acute Respiratory Distress Syndrome (ARDS), hypoxia, cyanosis, multiorgan dysfunction and disseminated intravascular coagulation, death
		Persistent pain or pressure in the chest
		ARDS
		Hypoxia
		Cyanosis
		Multiorgan dysfunction
		Disseminated Intravascular Coagulation
		Death
		ARDS occurs in 20% of people who gets COVID-19		Malaria-ARDS occurs in 25% of adults, 40% (children), 29% (pregnant women), 21-23 % (non-immune patients)
	Others	Loss of taste and smell		Taste impairment - Bitter or metallic taste
	Outcomes	Fatal in elderly, medical co-morbidities, mild in children		Fatal in children, pregnant women, immune-compromised
		More in densely populated / urban slums and in racial minorities (blacks, Hispanics)		More in rural and densely populated / urban slums
Treatment		Empirical treatment with hydroxychloroquine/chloroquine, Azithromycin and other adjuvants		Chloroquine in countries were Plasmodium is still sensitive and artemisinin combination therapy in countries where there is chloroquine resistance
Incubation period		Average 5-6 days, Range:2 to 14 days		Average 7-14 days, Range 7-30 days
Pathophysiology of severe disease		A cytokine storm triggers an exaggerated inflammatory response that may damage the liver, blood vessels, kidneys, and lungs, and increase formation of blood clots throughout the body. ARDS from pulmonary thrombosis consequent to cytokine / inflammatory storm
		Thrombosis in other organs causing multi-organ dysfunction/failure and/or disseminated intravascular coagulation (DIC) as may occur in MA-ARD.