Publication date: Dec 11, 2025
The COVID-19 pandemic created novel diagnostic challenges for imported malaria due to overlapping symptoms and prioritized SARS-CoV-2 screening. This report presents a critical comparative analysis demonstrating how diagnostic delays during co-circulation directly impact malaria severity-an underreported phenomenon with significant clinical implications. Two male patients returning from Africa (Nigeria and CcF4te d’Ivoire) developed fever during mandatory COVID-19 quarantine in Shanghai, China (2021). Both initially tested negative for SARS-CoV-2. Case 1 experienced a 96-h diagnostic delay, progressing to severe falciparum malaria with delirium, thrombocytopenia (33 cD7 10⁹/L), and acute kidney injury (creatinine 278 μmol/L), requiring intensive care. Case 2 was diagnosed within 24 h via rapid diagnostic test and microscopy, receiving immediate artesunate treatment without severe complications. Diagnostic delay directly impacts severe malaria risk during COVID-19 co-circulation. Parallel testing for both pathogens in febrile travelers from endemic areas is critical. The proposed “48-Hour Three-Tier Diagnostic Response System” should shorten the diagnostic window.
| Concepts | Keywords |
|---|---|
| China | Diagnostic delay |
| Kidney | Imported malaria |
| Malaria | Parallel testing |
| Plasmodium falciparum | |
| Severe malaria |
Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | malaria |
| pathway | KEGG | Malaria |
| disease | MESH | COVID-19 |
| disease | MESH | Cte |
| disease | MESH | fever |
| disease | MESH | delirium |
| disease | MESH | thrombocytopenia |
| disease | MESH | acute kidney injury |
| drug | DRUGBANK | Creatinine |
| drug | DRUGBANK | Artesunate |