Dynamics of dengue and SARS-COV-2 co-infection in an endemic area of Colombia

Abstract

Since the COVID-19 outbreak, millions of people have been infected with SARS-CoV-2 around the world. An area of epidemiological relevance is Latin America, tropical regions, due to the distribution of endemic diseases such as chikungunya, dengue (DENV), malaria, Zika virus, where febrile disease abounds. The early signs and symptoms of DENV and COVID-19 could be similar, making it a risk that patients may be wrongly diagnosed early during the disease. The problem increases since COVID-19 infection can lead to false positives in DENV screening tests. We present two cases of acute undifferentiated febrile syndrome that were diagnosed with SARS-CoV-2 and DENV co-infection, confirmed by ELISA and RT-PCR for both viral pathogens. The occurrence of simultaneous or overlapped infections can alter the usual clinical course, severity, or outcome of each infection. Therefore, epidemiological surveillance and intensified preparation for those scenarios must be considered, as well as further studies should be done to address cases of co-infection promptly to avoid major complications and fatal outcomes during the current pandemic. Other endemic tropical diseases should not be neglected.

Arbovirus Transmission Predictions Are Affected by Both Temperature Data Source and Modeling Methodologies across Cities in Colombia

“…Without field studies for direct case detection coincident with ecological studies, it is impossible to identify the full swath of variables that define transmission in specific contexts. Finally, this study was during the pandemic lockdown in Colombia and epidemiological behavior might not be indicative of “normal” [ 65 , 66 ] and declining cases were reported in some places [ 67 , 68 ] as well as a COVID-related potential for misdiagnosis [ 69 , 70 ]. The SARS-CoV-2 pandemic arrested much activity in Colombia in the middle of sampling time.…”

Coinfections and Superinfections Associated with COVID-19 in Colombia: A Narrative Review

“…Initial differentiation between dengue and COVID-19 is a challenge as both infections have similar symptoms, such as fever, diarrhea, myalgia, and headache, and these overlap [ 64 , 65 ]. However, studies suggested that SARS-CoV-2 and DENV coinfection had less severe symptoms compared to isolated monoinfection [ 13 ]. Tropical countries, especially those with endemic DENV, approached a syndemic state, because multiple patients were coinfected with both SARS-CoV-2 and DENV.…”

“…COVID-19 can be misdiagnosed with dengue. This situation complicates matters, so it can be difficult to distinguish between early infections and coinfections, generating an important risk for the population and demanding greater attention from health systems, because both viruses can cause serious complications, mainly through the cytokine storm in lung tissue caused by macrophage hyperactivation [ 13 , 27 , 64 ].…”

“…In a study conducted in Colombia, a high incidence of early mortality associated with COVID-19 24 h after hospital admission was reported [ 11 ]. However, studies related to the incidence of coinfection and superinfection in patients with COVID-19 are generally limited, especially in Latin American countries [ 5 , 12 , 13 ]. It was observed that severely ill COVID-19 patients, especially those in the intensive care unit (ICU), were more prone to secondary infections, owing to the increased use of prophylactic or therapeutic antibiotics whose task is to ensure the successful eradication of susceptible pathogens [ 14 ].…”

COVID-19 and dengue coinfection in Veracruz, Mexico

“…In this area, cases of coinfection with more severe conditions have been reported that require a stay in intensive care units and even lead to death. A recent systematic review demonstrated serious and fatal cases with COVID-19 and Dengue coinfection, with cases reported in South America, Europe, and Asia [ [2] , [3] , [4] ].…”