Rujittika Mungmunpuntipantip1, Viroj Wiwanitkit2. 1. Private Academic Consultant, Bangkok, Thailand. 2. Department of Community Medicine, Dr. DY Patil University, Pune, Maharashtra, India.
Dear Editor,We read the report by Ram et al.[1] with great interest. Ram et al.[1] reported on the co-occurrence of COVID-19 and malaria and concluded that “Every suspected case of COVID encephalitis has to be investigated for all possible causes …….” In the present report, it is likely that there is a problem in the first complete blood count examination. In laboratory medicine, a blood smear examination should be routinely done, and it is usually neglected when an automated hematology analyzer is widely used. Because the incubation period for COVID-19 (14 days) and cerebral malaria (12 days) can overlap, it is no doubt that there might be a co-infection and a disease might be underdiagnosed.[2] Also, it is possible that malaria might be a recurrence, not a newly acquired infection, and co-manifest with COVID-19.[3] When hydroxychloroquine is used for the management of COVID-19, it might also manage malaria co-infection in some cases and co-infection might be finally underdiagnosed.