Serological cross-reaction and coinfection of dengue and COVID-19 in Asia: Experience from Indonesia

Masyeni, Sri; Santoso, Marsha S.; Widyaningsih, Putu Dyah; Asmara, DG Wedha; Nainu, Firzan; Harapan, Harapan; Sasmono, R. Tedjo

doi:10.1016/j.ijid.2020.10.043

Cited by 116 publications

(126 citation statements)

References 17 publications

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“…For tropical and sub-tropical dengue-endemic countries [ 46 ] developing serological tests specific to COVID-19 is quite challenging, for serological and symptomatologic overlap between the diseases in question [ 47 , 48 ]. Misdiagnosis of COVID-19 as dengue due to serological cross-reactivity has already been reported in Indonesia [ 49 , 50 ]. Singapore [ 51 ] and Thailand [ 52 ] and vice-versa for rapid COVID-19 antibody kits in India [ 53 ].…”

Section: Discussionmentioning

confidence: 99%

Development and performance evaluation of a rapid in-house ELISA for retrospective serosurveillance of SARS-CoV-2

Sil

Jahan²,

Haq³

et al. 2021

PLoS ONE

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Background In the ongoing pandemic situation of COVID-19, serological tests can complement the molecular diagnostic methods, and can be one of the important tools of sero-surveillance and vaccine evaluation. Aim To develop and evaluate a rapid SARS-CoV-2 specific ELISA for detection of anti-SARS-CoV2 IgG from patients’ biological samples. Methods In order to develop this ELISA, three panels of samples (n = 184) have been used: panel 1 (n = 19) and panel 2 (n = 60) were collected from RT-PCR positive patients within 14 and after 14 days of onset of clinical symptoms, respectively; whereas panel 3 consisted of negative samples (n = 105) collected either from healthy donors or pre-pandemic dengue patients. As a capturing agent full-length SARS-CoV2 specific recombinant nucleocapsid was immobilized. Commercial SARS-CoV2 IgG kit based on chemiluminescent assay was used for the selection of samples and optimization of the assay. The threshold cut-off point, inter-assay and intra-assay variations were determined. Results The incubation/reaction time was set at a total of 30 minutes with the sensitivity of 84% (95% confidence interval, CI, 60.4%, 96.6%) and 98% (95% CI, 91.1%, 100.0%), for panel 1 and 2, respectively; with overall 94.9% sensitivity (95% CI 87.5%, 98.6%). Moreover, the clinical specificity was 97.1% (95% CI, 91.9%, 99.4%) with no cross reaction with dengue samples. The overall positive and negative predictive values are 96.2% (95% CI 89.2%, 99.2%) and 96.2% (95% CI, 90.6% 99.0%), respectively. In-house ELISA demonstrated 100% positive and negative percent agreement with Elecsys Anti-SARS-CoV-2, with Cohen’s kappa value of 1.00 (very strong agreement), while comparing 13 positive and 17 negative confirmed cases. Conclusion The assay is rapid and can be applied as one of the early and retrospective sero-monitoring tools in all over the affected areas.

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Section: Discussionmentioning

confidence: 99%

Development and performance evaluation of a rapid in-house ELISA for retrospective serosurveillance of SARS-CoV-2

Sil

Jahan²,

Haq³

et al. 2021

PLoS ONE

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“…A number of countries with particularly severe COVID-19 epidemics regularly experience dengue epidemics (e.g., Peru, Brazil, and Indonesia), and there have been reports of 2020 being an above-average year for dengue in South America (7). A number of warnings have been raised regarding the potential dangers of overlapping dengue and COVID-19 epidemics; e.g., both diseases can result in similar symptoms and there have been reports of serological cross-reaction, which increases the chance of misdiagnosis (8–14). At least five cases of dengue-COVID-19 co-infection have been reported, one of which resulted in death by stroke (9,14– 18).…”

Section: Introductionmentioning

confidence: 99%

The impacts of COVID-19 mitigation on dengue virus transmission: a modelling study

España

et al. 2020

Preprint

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SummaryBackgroundThe COVID-19 pandemic has induced unprecedented reductions in human mobility and social contacts throughout the world. Because dengue virus (DENV) transmission is strongly driven by human mobility, behavioral changes associated with the pandemic have been hypothesized to impact dengue incidence. By discouraging human contact, COVID-19 control measures have also disrupted dengue vector control interventions, the most effective of which require entry into homes.MethodWe used an agent-based model with a realistic treatment of human mobility and vector control to investigate how and why dengue incidence could differ under a lockdown scenario with a proportion of the population sheltered at home.ResultWe found that a lockdown in which 70% of the population sheltered at home led to a small average increase in cumulative DENV infections of up to 10%, depending on the time of year lockdown occurred. Lockdown had a more pronounced effect on the spatial distribution of DENV infections, with higher incidence under lockdown in regions with high mosquito abundance. Transmission was also more focused in homes following lockdown. The proportion of people infected in their own home rose from 54% under normal conditions to 66% under lockdown, and the household secondary attack rate rose from 0.109 to 0.128, a 17% increase. When we considered that lockdown measures could disrupt regular, city-wide vector control campaigns, the increase in incidence was more pronounced than with lockdown alone, especially if lockdown occurred at the optimal time for vector control.DiscussionOur results indicate that an unintended outcome of COVID-19 control measures may be to adversely alter the epidemiology of dengue. This observation has important implications for an improved understanding of dengue epidemiology and effective application of dengue vector control. When coordinating public health responses during a syndemic, it is important to monitor multiple infections and understand that an intervention against one disease may exacerbate another.

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“…For tropical and sub-tropical dengue-endemic countries (42) developing serological tests specific to COVID-19 is quite challenging, for serological and symptomatological overlap between the diseases in question (43, 44). Misdiagnosis of COVID-19 as dengue due to serological cross-reactivity has already been reported in Indonesia (45, 46). Singapore (47) and Thailand (48) and vice-versa for rapid COVID-19 antibody kits in India (49).…”

Section: Discussionmentioning

confidence: 99%

Development And Performance Evaluation of A Rapid In-House ELISA for Retrospective Serosurveillance of SARS-CoV-2

Sil

Oishee

Haq³

et al. 2020

Preprint

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BackgroundIn the ongoing pandemic situation of COVID-19, serological tests can complement the molecular diagnostic methods, and can be one of the important tools of sero-surveillance and vaccine evaluation.AimTo develop and evaluate a rapid SARS-CoV-2 specific ELISA for detection of anti-SARS-CoV2 IgG from patient’s biological samples.MethodsIn order to develop the ELISA, three panels of samples (n=184) have been used: panel 1 (n=19) and panel 2 (n=60) were collected from RT-PCR positive patients within 14 and after 14 days of onset of clinical symptoms respectively, whereas panel 3 consisted of negative samples (n=105) collected either from healthy donors or pre-pandemic dengue patients. As a capturing agent full-length SARS-CoV2 specific recombinant nucleocapsid was immobilized. Commercial SARS-CoV2 IgG kit based on chemiluminescent assay was used for the selection of samples and optimization of the assay. The threshold cut-off point, inter-assay and intra-assay variations were determined. The total assay time for this in-house ELISA was set for 30 minutes.ResultsThe assay time was set at a total of 30 minutes with the sensitivity of 84% (95% confidence interval, CI, 60.4%, 96.6%) and 98% (95% CI, 91.1%, 100.0%), for panel 1 and 2 respectively, with over all 94.9% sensitivity (95% CI 87.5%, 98.6%). Moreover, the clinical specificity is 97.1% (95% CI, 91.9%, 99.4%) with no cross reaction with dengue sample. The overall positive and negative predictive values are 96.2% (95% CI 89.2%, 99.2%) and 96.2% (95% CI, 90.6% 99.0%) respectively. In-house ELISA demonstrated 100% positive and negative percent agreement with ROCHE (Elecsys; Anti-SARS-CoV-2), with a Cohen’s kappa value of 1.00 (very strong agreement), while comparing 13 positive and 17 negative confirmed cases.ConclusionThe assay is rapid and can be applied as one of the early and retrospective sero-monitoring tools in all over the affected areas.

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Serological cross-reaction and coinfection of dengue and COVID-19 in Asia: Experience from Indonesia

Cited by 116 publications

References 17 publications

Development and performance evaluation of a rapid in-house ELISA for retrospective serosurveillance of SARS-CoV-2

Development and performance evaluation of a rapid in-house ELISA for retrospective serosurveillance of SARS-CoV-2

The impacts of COVID-19 mitigation on dengue virus transmission: a modelling study

Development And Performance Evaluation of A Rapid In-House ELISA for Retrospective Serosurveillance of SARS-CoV-2

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