Detection of SARS-CoV-2 antibodies in febrile patients from an endemic region of dengue and chikungunya in Peru

Abstract

Introduction The rapid expansion of the novel SARS-CoV-2 virus has raised serious public health concerns due to the possibility of misdiagnosis in regions where arboviral diseases are endemic. We performed the first study in northern Peru to describe the detection of SARS-CoV-2 IgM antibodies in febrile patients with a suspected diagnosis of dengue and chikungunya fever. Materials and methods A consecutive cross-sectional study was performed in febrile patients attending primary healthcare centers from April 2020 through March 2021. Patients enrolled underwent serum sample collection for the molecular and serological detection of DENV and CHIKV. Also, serological detection of IgM antibodies against SARS-CoV-2 was performed. Results 464 patients were included during the study period, of which (40.51%) were positive for one pathogen, meanwhile (6.90%) presented co-infections between 2 or more pathogens. The majority of patients with monoinfections were positive for SARS-CoV-2 IgM with (73.40%), followed by DENV 18.09% and CHIKV (8.51%). The most frequent co-infection was DENV + SARS-CoV-2 with (65.63%), followed by DENV + CHIKV and DENV + CHIKV + SARS-CoV-2, both with (12.50%). The presence of polyarthralgias in hands (43.75%, p<0.01) and feet (31.25%, p = 0.05) were more frequently reported in patients with CHIKV monoinfection. Also, conjunctivitis was more common in patients positive for SARS-CoV-2 IgM (11.45%, p<0.01). The rest of the symptoms were similar among all the study groups. Conclusion SARS-CoV-2 IgM antibodies were frequently detected in acute sera from febrile patients with a clinical suspicion of arboviral disease. The presence of polyarthralgias in hands and feet may be suggestive of CHIKV infection. These results reaffirm the need to consider SARS-CoV-2 infection as a main differential diagnosis of acute febrile illness in arboviruses endemic areas, as well as to consider co-infections between these pathogens.

Continuous Circulation of Chikungunya Virus during COVID-19 Pandemic in Jambi, Sumatra, Indonesia

“…The samples in this study were collected while the COVID-19 pandemic was still ongoing in the country. Studies that were conducted in countries endemic to Chikungunya show that CHIKV continued to circulate and cause disease during the COVID-19 pandemic [15] with possible coinfections [16]. Despite the relatively low incidence of COVID-19 in Jambi during the month in which this study was conducted, the mobility restrictions as a measure of COVID-19 transmission control that are still implemented in cities, including Jambi, create difficulties in other disease surveillance during a pandemic.…”

“…The samples in this study were collected while the COVID-19 pandemic was still ongoing in the country. Studies that were conducted in countries endemic to Chikungunya show that CHIKV continued to circulate and cause disease during the COVID-19 pandemic [15] with possible coinfections [16]. Despite the relatively low in-…”

Occurrence of False-Positive Tests and Cross-reactions Between COVID-19 and Dengue With Implications During Diagnosis: A Mixed Evidence Synthesis

“…In the same study, more patients were tested positive for SARS-CoV-2 than for dengue virus, which concurs with our findings. 66 Perhaps, healthcare professionals should pay more attention to AFI cases while considering the possibility of SARS-CoV-2. Despite the perplexity of clinical manifestations of the viruses and falsepositive/cross-reaction associated with them, symptoms, such as anosmia, dysgeusia, diarrhea and cough, were specific to COVID-19 patients.…”

“…Studies have shown that when individuals are quarantined, they experience loneliness, anger, posttraumatic stress and confusion 69 . These feelings escalate as a result of paranoia associated with the infection, the period of quarantine, frustration, boredom and stigmatization 66 …”

Chikungunya Virus Infection in Pre-Covid-19 and Covid-19 Era; an Observation from a Tertiary Care Hospital, the State of Uttar Pradesh

“…The mobility restriction during pandemic has affected the health-seeking behaviour of people [11]. Similar studies that were conducted in countries endemic to Chikungunya show that CHIKV continued to circulate and cause disease during the COVID-19 pandemic [12] with possible coinfections [13]. Due to the lack of specific clinical presentation for CHIKV infection, efficient and accurate diagnostic methods are necessary for the proper management [14,15].…”