Invisible Facial Flushing in Two Cases of Dengue Infection and Influenza Detected by PC Program and Smartphone App: Decorrelation Stretching and K-Means Clustering

Arpornsuwan, Manote; Arpornsuwan, Matinun

doi:10.1155/2020/8790130

Cited by 3 publications

(1 citation statement)

References 14 publications

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“…Facial flushing is considered a sensitive and specific marker of disease. 26 We found a very strong association of facial or neck flushing with dengue compared with COVID-19, which, given this finding in about half of our dengue cases, could support its diagnosis if regularly elicited during the patient interview. Thrombocytopenia also had a strong association with dengue and was found in about two-thirds of the dengue cases in our analysis.…”

Section: Discussionsupporting

confidence: 60%

Clinical Features of COVID-19, Dengue, and Influenza among Adults Presenting to Emergency Departments and Urgent Care Clinics—Puerto Rico, 2012–2021

Wong

Volkman

Adams

et al. 2023

The American Journal of Tropical Medicine and Hygiene

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Dengue and influenza are pathogens of global concern and cause febrile illness similar to COVID-19. We analyzed data from an enhanced surveillance system operating from three emergency departments and an urgent care clinic in Puerto Rico to identify clinical features predictive of influenza or dengue compared with COVID-19. Participants with fever or respiratory symptoms and aged ≥18 years enrolled May 2012–January 2021 with dengue, influenza, or SARS-CoV-2 confirmed by reverse transcriptase polymerase chain reaction were included. We calculated adjusted odds ratios (aORs) and 95% CIs using logistic regression to assess clinical characteristics of participants with COVID-19 compared to those with dengue or influenza, adjusting for age, subregion, and days from illness onset to presentation for clinical care. Among 13,431 participants, we identified 2,643 with dengue (N = 303), influenza (N = 2,064), or COVID-19 (N = 276). We found differences in days from onset to presentation among influenza (2 days [interquartile range: 1–3]), dengue (3 days [2–4]), and COVID-19 cases (4 days [2–7]; P < 0.001). Cough (aOR: 0.12 [95% CI: 0.07–0.19]) and shortness of breath (0.18 [0.08–0.44]) were less common in dengue compared with COVID-19. Facial flushing (20.6 [9.8–43.5]) and thrombocytopenia (24.4 [13.3–45.0]) were more common in dengue. Runny nose was more common in influenza compared with COVID-19 (8.3 [5.8–12.1]). In summary, cough, shortness of breath, facial flushing, and thrombocytopenia helped distinguish between dengue and COVID-19. Although few features distinguished influenza from COVID-19, presentation > 4 days after symptom onset suggests COVID-19. These findings may assist clinicians making time-sensitive decisions regarding triage, isolation, and management while awaiting pathogen-specific testing.

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Section: Discussionsupporting

confidence: 60%