Dengue &amp; COVID-19: A Comparison and the Challenges at Hand

Introduction: Overlapping symptoms between dengue and COVID-19 may become diagnostic challenge; moreover, social stigma and fear of being diagnosed with COVID-19 may lead the patients to delayed medical visit. Delayed medical management of dengue may lead to expanded dengue syndrome and fatal outcome. Case Presentation: A 35-year-old female patient with uncontrolled diabetes mellitus and recent COVID-19 infection presented with continuous fever for four days. She delayed seeking medical advice due to traumatized being infected by COVID-19, self-isolation protocol, and COVID-19 protocol in every hospital for every febrile patient. She developed multi organ failure during hospitalization and was diagnosed with expanded dengue syndrome. Clinical Discussion: Diagnosing the etiology of acute febrile illness in the COVID-19 pandemic era is problematic. Most of healthcare facilities warranted COVID-19 evaluation in every acute febrile patient. This protocol may lead to potential delayed diagnosis and serve as a barrier to accessing healthcare facility. False perception, fear and anxiety of being isolated, discrimination in society, and others may lead to stigmatization of COVID-19 and affect the individual decision for COVID-19 testing and seeking medical advices. Our patient had a fatal outcome due to delayed detection and treatment of dengue hemorrhagic fever. Conclusion: Delayed management of expanded dengue syndrome leads to fatal outcome. Stigma may play role as the barrier for seeking medical advice. Having broad differential diagnosis in COVID-19 pandemic era is essential.

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“…Alla et al . 8 had listed the comparison between dengue and COVID-19, which share common clinical manifestations that may lead to misdiagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…Ordering specific diagnostic tests, such NS-1, antibody test for dengue, and COVID-19 testing, may help the diagnosis. However, not all healthcare facilities can access those testing, especially in developing countries 8 . Another challenge is the possibility of coexistent of COVID-19 with other infectious diseases 5 .…”

Section: Discussionmentioning

confidence: 99%

Expanded dengue syndrome in diabetic patient with history of COVID-19 infection: a case report

Nelwan

Pramanta²,

Safitri³

et al. 2023

Annals of Medicine &Amp; Surgery

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“…However, such cases need to be handled with caution with respect to the disease diagnosis and management due to the overlapping of several clinical manifestations of dengue and COVID‐19 infections, including pathophysiology, innate immune responses and humoral immune responses. Additional drawbacks include false positive serological tests due to cross‐reactivity and overlapping of the laboratory findings that confuse the diagnosis and complicate patient management 21 …”

Section: Methodsmentioning

confidence: 99%

“…Additional drawbacks include false positive serological tests due to cross‐reactivity and overlapping of the laboratory findings that confuse the diagnosis and complicate patient management. 21 …”

Section: Methodsmentioning

confidence: 99%

Dengue fever coinfection in COVID‐19 era: A public health concern

Jal,

Chhotaray,

Pattnaik

et al. 2024

Health Science Reports

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Background and AimDengue and SARS‐CoV‐2 coinfection is commonly encountered and constantly reported in particularly the dengue‐endemic regions thus posing a co‐epidemic threat. Coinfection is also significantly associated with morbidity and mortality. Comorbidity risk during a coinfection is of a greater concern. Although the pathophysiologies of the two infections vary, their identical clinical symptoms during coinfection result in diagnostic and therapeutic complexities.MethodsA literature search for the current relevant reports was carried out. The searched databases were Scopus, PubMed, Google Scholar and the Web of Science, with health agencies like the WHO. Based on the selection criteria, the most recent and pertinent reports published in English language were included for the ease of understanding, deciphering and analysing the secondary data.ResultsA delay in proper diagnosis of coinfection could result in serious complications with poor patient outcome. Whether it is a standalone dengue or COVID‐19 infection or a coinfection, specific biomarkers may be utilized for its foolproof diagnosis. This article highlights the various diagnostic techniques and immune responses from the perspective of prompt and appropriate public health management for patients suffering from COVID‐19 and dengue viral coinfections, both being independently or collectively capable of damaging a human body.ConclusionAs coinfection poses significantly large burden on an already‐fragile healthcare facility, constant monitoring of a coinfected patient is needed for prompt and suitable therapeutics. Also, to maintain high vigilance and invoke appropriate preventive measures particularly in dengue endemic regions, the government, healthcare authority and the general public need to collaborate and cooperate.

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“…Presently there are multiple reports showing modest serological cross-reactivity between SARS-CoV-2 and DENV-2, significantly impacting dengue diagnostics [7] [8] [9]. However, it is yet unclear if this would have any clinical impact on dengue cases [10].…”

Section: Introductionmentioning

confidence: 99%

SARS-CoV-2 antibodies cross-react and enhance dengue infection

Jakhar,

Sonar,

Singh

et al. 2023

Preprint

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Dengue disease is highly prevalent in tropical and subtropical regions worldwide. However, its pathogenesis is still incompletely understood, particularly in comparison to other endemic viruses. Antibody-dependent enhancement (ADE) is a well-known phenomenon for dengue viruses. Given the recent surge in dengue cases and potential cross-reactivity with SARS-CoV-2 antibodies, this study explores the impact of anti-SARS-CoV-2 antibodies on DENV-2 infection.The study assessed the cross-reactivity of SARS-CoV-2 antibodies with the DENV-2 Virus. Human convalescent plasma samples collected during different waves of COVID-19 and monoclonal and polyclonal antibodies raised against SARS-CoV-2 were examined for their potential to cause ADE of DENV-2 infection using cell-based assays. The study found that anti-SARS-CoV-2 antibodies acquired from natural infection in humans or through experimental immunization in animals were cross-reactive with DENV-2 and had the potential to enhance DENV-2 infection in K562 and U937 cells. In-silico and in-vitro studies indicated a strong interaction between SARS-CoV-2 antibodies and DENV-2 E-protein, providing a molecular basis for these findings. This study is the first to demonstrate that anti-SARS-CoV-2 antibodies can cross-react with DENV-2 and can enhance its infection through ADE. These findings have implications for SARS-CoV-2 vaccine development and deployment strategies in regions where dengue is endemic.SummaryAntibodies against SARS-CoV-2 (RBD and Spike) showed significant cross reactivity with DENV-2 (E protein). Also, anti-SARS-CoV-2-commercial antibodies, immunised animal sera and 46 human convalescent plasma samples (from different waves of pandemic) demonstrated antibody-dependent enhancement (ADE) of DENV-2 infection.

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Dengue & COVID-19: A Comparison and the Challenges at Hand

Cited by 7 publications

References 26 publications

Expanded dengue syndrome in diabetic patient with history of COVID-19 infection: a case report

Expanded dengue syndrome in diabetic patient with history of COVID-19 infection: a case report

Dengue fever coinfection in COVID‐19 era: A public health concern

SARS-CoV-2 antibodies cross-react and enhance dengue infection

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