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Korishetty V, Rao P, Shenoy S, Jeppu U, B K. Analysis of Dengue and SARS-CoV-2 Coinfection in a Tertiary Care Hospital: A Retrospective Study. J Trop Med 2024; 2024:6788850. [PMID: 39345300 PMCID: PMC11427724 DOI: 10.1155/2024/6788850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 06/05/2024] [Accepted: 09/04/2024] [Indexed: 10/01/2024] Open
Abstract
Introduction Coinfection of dengue virus and SARS-CoV-2 infections in dengue-endemic areas is a significant public health concern. Coinfections can result in severe illness. Hence, this study determines the incidence of dengue and COVID-19 coinfection for a better understanding of the clinical presentation, laboratory parameters, and outcomes including mortality. Methods The patients admitted to two tertiary hospitals with RT PCR-proven COVID-19 infection and dengue positive by NS1 rapid antigen or IgM dengue ELISA for two years between January 2020 and December 2022 were considered. Clinical data were retrieved from medical records including the laboratory findings and outcomes of these patients. The categorical data were analyzed in the form of frequency and proportion. The quantitative data were analyzed in the form of mean, median, and proportion. Results Out of 2301 confirmed dengue samples and 3718 confirmed COVID-19 samples, there were 14 cases of coinfection with the presence of COVID-19 and dengue infection at the same time. ICU admission of 14.2% and mean hospital stay of 7 days were noted. Mainly the symptoms reported were fever at 92.9%, myalgia at 35.7%, and headache, vomiting, and cough at 28.6%. The laboratory findings were elevated lactate dehydrogenase and C-reactive protein in 100% of patients, elevated ferritin in 92.9%, thrombocytopenia in 71.4%, elevated AST and ALT in 71.4%, and elevated D-dimer in 57.1% of patients. There was no effect on morbidity and mortality seen among coinfection. Conclusion COVID-19 and dengue share similar clinical features and laboratory findings. Diagnosis of one disease cannot rule out the presence of other infections. There might be chances of misdiagnosis or missed diagnosis. Hence, it is important to stress about early detection using specific methods and confirmation of disease with timely management, as it is a potentially new dimension for public health concern and management.
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Affiliation(s)
- Vinayaka Korishetty
- Kasturba Medical College Mangalore Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India
| | - Pooja Rao
- Kasturba Medical College Mangalore Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India
| | - Suchitra Shenoy
- Kasturba Medical College Mangalore Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India
| | - Udayalaxmi Jeppu
- Kasturba Medical College Mangalore Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India
| | - Keerthiraj B
- Kasturba Medical College Mangalore Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India
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Al-Emran HM, Rahman F, Sarkar L, Das PK, Mondol P, Yesmin S, Sultana P, Ahammed T, Parvez R, Hasan MS, Sarkar SL, Rahman MS, Hossain A, Rahman M, Islam OK, Islam MT, Nigar S, Akter S, Rubayet Ul Alam ASM, Rahman MM, Jahid IK, Hossain MA. Emergence of SARS-CoV-2 Variants Are Induced by Coinfections With Dengue. Bioinform Biol Insights 2024; 18:11779322241272399. [PMID: 39290577 PMCID: PMC11406487 DOI: 10.1177/11779322241272399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 06/29/2024] [Indexed: 09/19/2024] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that emerged in late 2019 has accumulated a series of point mutations and evolved into several variants of concern (VOCs), some of which are more transmissible and potentially more severe than the original strain. The most notable VOCs are Alpha, Beta, Gamma, Delta, and Omicron, which have spread to various parts of the world. This study conducted surveillance in Jashore, Bangladesh to identify the prevalence of SARS-CoV-2 coinfected with dengue virus and their genomic effect on the emergence of VOCs. A hospital-based COVID-19 surveillance from June to August, 2021 identified 9 453 positive patients in the surveillance area. The study enrolled 572 randomly selected COVID-19-positive patients, of which 11 (2%) had dengue viral coinfection. Whole genome sequences of SARS-CoV-2 were analyzed and compared between coinfection positive and negative group. In addition, we extracted 185 genome sequences from GISAID to investigate the cross-correlation function between SARS-CoV-2 mutations and VOC; multiple ARIMAX(p,d,q) models were developed to estimate the average number of amino acid (aa) substitution among different SARS-CoV-2 VOCs. The results of the study showed that the coinfection group had an average of 30.6 (±1.7) aa substitutions in SARS-CoV-2, whereas the dengue-negative COVID-19 group had that average of 25.6 (±1.8; P < .01). The coinfection group showed a significant difference of aa substitutions in open reading frame (ORF) and N-protein when compared to dengue-negative group (P = .03). Our ARIMAX models estimated that the emergence of SARS-CoV-2 variants Delta required additional 9 to 12 aa substitutions than Alpha, Beta, or Gamma variant. The emergence of Omicron accumulated additional 19 (95% confidence interval [CI]: 15.74, 21.95) aa substitution than Delta. Increased number of point mutations in SARS-CoV-2 genome identified from coinfected cases could be due to the compromised immune function of host and induced adaptability of pathogens during coinfections. As a result, new variants might be emerged when series of coinfection events occur during concurrent two epidemics.
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Affiliation(s)
- Hassan M Al-Emran
- Department of Biomedical Engineering, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Fazlur Rahman
- Department of Accounting and Information Systems, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Laxmi Sarkar
- Department of Microbiology, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Prosanto Kumar Das
- Department of Microbiology, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Provakar Mondol
- Department of Microbiology, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Suriya Yesmin
- Department of Microbiology, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Pipasha Sultana
- Department of Microbiology, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Toukir Ahammed
- Department of Microbiology, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Rasel Parvez
- Department of Microbiology, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Md Shazid Hasan
- Department of Microbiology, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Shovon Lal Sarkar
- Department of Microbiology, Jashore University of Science and Technology, Jashore, Bangladesh
| | - M Shaminur Rahman
- Department of Microbiology, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Anamica Hossain
- Department of Microbiology, Dhaka University, Dhaka, Bangladesh
| | | | - Ovinu Kibria Islam
- Department of Microbiology, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Md Tanvir Islam
- Department of Microbiology, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Shireen Nigar
- Department of Nutrition and Food Technology, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Selina Akter
- Department of Microbiology, Jashore University of Science and Technology, Jashore, Bangladesh
| | - A S M Rubayet Ul Alam
- Department of Microbiology, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Mohammad Mahfuzur Rahman
- Department of Climate and Disaster Management, Jashore University of Science and Technology, Jashore, Bangladesh
| | - Iqbal Kabir Jahid
- Department of Microbiology, Jashore University of Science and Technology, Jashore, Bangladesh
- Genome Centre, Jashore University of Science and Technology, Jashore, Bangladesh
| | - M Anwar Hossain
- Genome Centre, Jashore University of Science and Technology, Jashore, Bangladesh
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3
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Dalugama C, Seneviratne SL. Dengue and COVID-19 co-infections: an important consideration in the tropics. Trans R Soc Trop Med Hyg 2022; 117:241-254. [PMID: 36479900 DOI: 10.1093/trstmh/trac114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 08/19/2022] [Accepted: 11/18/2022] [Indexed: 12/13/2022] Open
Abstract
Abstract
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has affected >370 million individuals worldwide. Dengue is endemic in many countries and leads to epidemics at frequent intervals. In the tropics and subtropics, it is possible that individuals may be concurrently infected with both dengue and SARS-CoV-2. Differentiation between the two infections may be difficult from both a clinical and laboratory perspective. We have outlined the currently published findings (as of the end of December 2021) on patients with dengue and SARS-CoV-2 co-infections and have discussed the observed outcomes and management of such patients. Co-infections were more common in males >25 y of age, fever was not universal, 30–50% had medical comorbidities such as diabetes mellitus or hypertension and the case fatality rate was 16–28%.
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Affiliation(s)
- Chamara Dalugama
- Department of Medicine, Faculty of Medicine, University of Peradeniya , Peradeniya, Sri Lanka
| | - Suranjith L Seneviratne
- Institute of Immunity and Transplantation, Royal Free Hospital and University College London , London, UK
- Nawaloka Hospital Research and Education Foundation, Nawaloka Hospitals , Colombo , Sri Lanka
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4
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León-Figueroa DA, Abanto-Urbano S, Olarte-Durand M, Nuñez-Lupaca JN, Barboza JJ, Bonilla-Aldana DK, Yrene-Cubas RA, Rodriguez-Morales AJ. COVID-19 and dengue coinfection in Latin America: A systematic review. New Microbes New Infect 2022; 49:101041. [PMID: 36320316 PMCID: PMC9613782 DOI: 10.1016/j.nmni.2022.101041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 10/18/2022] [Accepted: 10/20/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction Coronavirus Disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has spread globally, becoming a long-lasting pandemic. Dengue is the most common arboviral disease in tropical and subtropical regions worldwide. COVID-19 and dengue coinfections have been reported, associated with worse outcomes with significant morbidity and mortality. Therefore, this study aims to determine the epidemiological situation of COVID-19 and dengue coinfection in Latin America. Methods A systematic literature review was performed using PubMed, Scopus, Embase, Web of Science, LILACS, and BVS databases from January 1, 2020, to September 4, 2021. The key search terms used were "dengue" and "COVID-19". Results Nineteen published articles were included. The studies were case reports with a detailed description of the coinfection's clinical, laboratory, diagnostic, and treatment features. Conclusion Coinfection with SARS-CoV-2 and dengue virus is associated with worse outcomes with significant morbidity and mortality. The similar clinical and laboratory features of each infection are a challenge in accurately diagnosing and treating cases. Establishing an early diagnosis could be the answer to reducing the estimated significant burden of these conditions.
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Affiliation(s)
- Darwin A. León-Figueroa
- Facultad de Medicina Humana, Universidad de San Martín de Porres, Chiclayo, Peru
- Unidad de Revisiones Sistemáticas y Meta-análisis, Tau-Relaped Group, Trujillo, Peru
| | - Sebastian Abanto-Urbano
- Sociedad Científica de Estudiantes de Medicina Villarrealinos (SOCEMVI), Lima, Peru
- Facultad de Medicina, Universidad Nacional Federico Villarreal, Lima, Peru
| | - Mely Olarte-Durand
- Facultad de Medicina Humana, Sociedad Científica de Estudiantes de Medicina (SOCEM UPEU), Lima, Peru
- Universidad Peruana Unión, Lima, Peru
| | - Janeth N. Nuñez-Lupaca
- Centro Científico Basadrino de Estudiantes de Medicina (CECIBEM), Tacna, Peru
- Escuela Profesional de Medicina Humana, Universidad Nacional Jorge Basadre Grohmann, Tacna, Peru
| | | | | | - Robinson A. Yrene-Cubas
- Sociedad Científica de Estudiantes de Medicina de la Universidad Científica del Sur (SCIEM UCSUR), Lima, Peru
- Facultad de Medicina Humana, Universidad Científica del Sur, Lima, Peru
| | - Alfonso J. Rodriguez-Morales
- Grupo de Investigación Biomedicina, Faculty of Medicine, Fundacion Universitaria Autonoma de las Americas, Pereira, Risaralda, Colombia
- Latin American Network of COVID-19 Research (LANCOVID), Pereira, Risaralda, Colombia
- Clinical Epidemiology and Biostatistics, Universidad Cientifica del Sur, Lima, Peru
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5
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Patil SV, Bhadake M, Acharya A. ‘Dengue-COVID-19 overlap’: Is it an ‘antigenic mimicry’ or coexistent two different viral genotypic diseases? Prospective, observational study in tertiary care setting in India. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2022. [DOI: 10.29333/ejgm/12279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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6
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Hannan TB, Hossain Z, Hasan MN, Khan AH, Alam MR, Rahman MM, Arafat SM, Chowdhury FR. Clinical and laboratory characteristics of dengue and COVID-19 coinfected patients in Dhaka, Bangladesh. Trans R Soc Trop Med Hyg 2022; 117:50-54. [PMID: 35443278 PMCID: PMC9047248 DOI: 10.1093/trstmh/trac031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 03/03/2022] [Accepted: 03/23/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Dengue-COVID-19 coinfection is one of the greatest emerging challenges in dengue-endemic areas during the continuing pandemic. With coinciding clinical and laboratory pictures, early diagnosis becomes burdensome, with management discrepancy. METHODS A descriptive study was performed on dengue-COVID-19 coinfected patients during July-August 2021 for an overview of disease progression, severity and outcome. A total of 11 patients who were positive for dengue NS1 and/or antidengue IgM were included in this study. RESULTS In total, 45.5% patients developed severe COVID-19 disease, 45.5% patients developed group B dengue fever and 9% patients developed group C dengue fever. Concurrent severity of both diseases was seen to be rare, except for in one patient. CONCLUSION Early diagnosis and compatible management still stand as basic principles to prevent fatality and morbidity.
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Affiliation(s)
- Tabiha Binte Hannan
- Department of Internal Medicine, Bangabandhu Sheikh Mujib Medical University, Shahbagh, Dhaka, 1217, Bangladesh
| | - Zazeba Hossain
- Department of Internal Medicine, Bangabandhu Sheikh Mujib Medical University, Shahbagh, Dhaka, 1217, Bangladesh
| | - Md Nazmul Hasan
- Department of Internal Medicine, Bangabandhu Sheikh Mujib Medical University, Shahbagh, Dhaka, 1217, Bangladesh
| | - Abed Hussain Khan
- Department of Internal Medicine, Bangabandhu Sheikh Mujib Medical University, Shahbagh, Dhaka, 1217, Bangladesh
| | - Md Rafiqul Alam
- Department of Internal Medicine, Bangabandhu Sheikh Mujib Medical University, Shahbagh, Dhaka, 1217, Bangladesh
| | - Md Mujibur Rahman
- Department of Internal Medicine, Bangabandhu Sheikh Mujib Medical University, Shahbagh, Dhaka, 1217, Bangladesh
| | - Shohael Mahmud Arafat
- Department of Internal Medicine, Bangabandhu Sheikh Mujib Medical University, Shahbagh, Dhaka, 1217, Bangladesh
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7
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El-Qushayri AE, Kamel AMA, Reda A, Ghozy S. Does dengue and COVID-19 co-infection have worse outcomes? A systematic review of current evidence. Rev Med Virol 2022; 32:e2339. [PMID: 35213764 PMCID: PMC9111070 DOI: 10.1002/rmv.2339] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 02/01/2022] [Accepted: 02/16/2022] [Indexed: 12/13/2022]
Abstract
In dengue-endemic regions, the co-infection with SARS-CoV-2 and dengue is a significant health concern. Therefore, we performed a literature search for relevant papers in seven databases on 26 Spetember 2021. Out of 24 articles, the mortality rate and intensive care unit (ICU) admission were 19.1% and 7.8%, respectively. The mean hospital stay was 11.4 days. In addition, we identified two pregnancies with dengue and COVID-19 co-infection; one ended with premature rupture of membrane and intrauterine growth restriction fetus, while the other one ended with maternal mortality and intrauterine fetal death. COVID-19 and dengue co-infection had worse outcomes regarding mortality rates, ICU admission, and prolonged hospital stay. Thus, wise-decision management approaches should be adequately offered to these patients to enhance their outcomes. Establishing an early diagnosis might be the answer to reducing the estimated significant burden of these conditions.
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Affiliation(s)
| | | | - Abdullah Reda
- Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Sherief Ghozy
- Neuroradiology Department, Mayo Clinic, Rochester, Minnesota, USA.,Nuffield Department of Primary Care Health Sciences and Department for Continuing Education (EBHC Program), Oxford University, Oxford, UK
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8
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Wei KC, Sy CL, Wang WH, Wu CL, Chang SH, Huang YT. Major acute cardiovascular events after dengue infection-A population-based observational study. PLoS Negl Trop Dis 2022; 16:e0010134. [PMID: 35130277 PMCID: PMC8853534 DOI: 10.1371/journal.pntd.0010134] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 02/17/2022] [Accepted: 01/03/2022] [Indexed: 11/19/2022] Open
Abstract
Background Dengue virus (DENV) infection may be associated with increased risks of major adverse cardiovascular effect (MACE), but a large-scale study evaluating the association between DENV infection and MACEs is still lacking. Methods and findings All laboratory confirmed dengue cases in Taiwan during 2009 and 2015 were included by CDC notifiable database. The self-controlled case-series design was used to evaluate the association between DENV infection and MACE (including acute myocardial infarction [AMI], heart failure and stroke). The "risk interval" was defined as the first 7 days after the diagnosis of DENV infection and the "control interval" as 1 year before and 1 year after the risk interval. The incidence rate ratio (IRR) and 95% confidence interval (CI) for MACE were estimated by conditional Poisson regression. Finally, the primary outcome of the incidence of MACEs within one year of dengue was observed in 1,247 patients. The IRR of MACEs was 17.9 (95% CI 15.80–20.37) during the first week after the onset of DENV infection observed from 1,244 eligible patients. IRR were significantly higher for hemorrhagic stroke (10.9, 95% CI 6.80–17.49), ischemic stroke (15.56, 95% CI 12.44–19.47), AMI (13.53, 95% CI 10.13–18.06), and heart failure (27.24, 95% CI 22.67–32.73). No increased IRR was observed after day 14. Conclusions The risks for MACEs are significantly higher in the immediate time period after dengue infection. Since dengue infection is potentially preventable by early recognition and vaccination, the dengue-associated MACE should be taken into consideration when making public health management policies. Dengue infection is the most rapidly spreading mosquito-borne viral illness worldwide and becomes a vivid threat to non-tropical countries. Previous research has documented that viral infection can increase risks of adverse cardiovascular events. There were sporadic reports about the association of cardiovascular events and dengue infection in the endemic tropical countries. Our study analyzed the risks for major adverse cardiovascular events, and found that acute myocardial infarction, stroke and heart failure were significantly higher in the immediate time period (within one week) after dengue infection, especially in patients with ≥60 years of age, female gender and severe admission dengue cases.
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Affiliation(s)
- Kai-Che Wei
- Department of Dermatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Cheng-Len Sy
- Department of Internal Medicine, Division of Infectious Diseases, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Wen-Hwa Wang
- Department of Internal Medicine, Division of Cardiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Health Management Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- College of Management, I-Shou University, Kaohsiung, Taiwan
| | - Chia-Ling Wu
- Department of Medical Research and Development, Center for Big Data Analytics and Statistics, Chang Gung Memorial Hospital Linkou Main Branch, Taoyuan, Taiwan
| | - Shang-Hung Chang
- Department of Medical Research and Development, Center for Big Data Analytics and Statistics, Chang Gung Memorial Hospital Linkou Main Branch, Taoyuan, Taiwan
- Department of Internal Medicine, Division of Cardiology, Chang Gung Memorial Hospital Linkou Main Branch, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- * E-mail: (SH-C); (YT-H)
| | - Yu-Tung Huang
- Department of Medical Research and Development, Center for Big Data Analytics and Statistics, Chang Gung Memorial Hospital Linkou Main Branch, Taoyuan, Taiwan
- * E-mail: (SH-C); (YT-H)
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Pereira SM, do Nascimento CT, Ferro RS, Flores EF, Maldonado Bertacco EA, Fonseca EDS, Prestes-Carneiro LE. Double Trouble: Dengue Followed by COVID-19 Infection Acquired in Two Different Regions: A Doctor's Case Report and Spatial Distribution of Cases in Presidente Prudente, São Paulo, Brazil. Trop Med Infect Dis 2021; 6:156. [PMID: 34449753 PMCID: PMC8396357 DOI: 10.3390/tropicalmed6030156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/06/2021] [Accepted: 08/20/2021] [Indexed: 11/16/2022] Open
Abstract
Co-epidemics of COVID-19 and dengue in dengue-endemic countries represent a serious public health concern. In Brazil, São Paulo state ranks first for cases and deaths from COVID-19, and dengue is endemic in most regions of the country. In 2020, an outbreak of dengue occurred in western São Paulo. We determined the spatiotemporal distribution of dengue in the context of COVID-19 cases in Presidente Prudente, a mid-sized city in western São Paulo. To illustrate the burden of both infections, a case report of a doctor and his family, infected with dengue and COVID-19, is presented. There were three clusters of dengue and COVID-19 in the periphery. A dengue cluster was found in a region where there were no corresponding COVID-19 cases. Meanwhile, there were COVID-19 clusters where dengue activity was lower. In 2020, the COVID-19 epidemic emerged when dengue reached its seasonal peak, resulting in a simultaneous outbreak of both diseases. Lower rates of dengue were found in the city compared with 2019, and the fear of patients with mild dengue symptoms about remaining in hospital and acquiring COVID-19 infection may be the main cause. Simultaneous spatial clusters of dengue and COVID-19 in environmentally and socioeconomically vulnerable areas can guide public health authorities in intensive interventions to improve clinical diagnosis, epidemiological surveillance, and management of both diseases. The patient and his family were first infected with dengue and he then carried COVID-19 to his family, reinforcing the risk of health care workers spreading the virus to the community. We highlight the epidemiological significance of presenting a case report and spatial analysis of COVID-19 in the same study in the context of a dengue outbreak.
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Affiliation(s)
- Sérgio Munhoz Pereira
- Department of Emergency, Regional Hospital of Presidente Prudente, Oeste Paulista University, São Paulo 19050-920, Brazil; (S.M.P.); (C.T.d.N.); (R.S.F.); (L.E.P.-C.)
| | - Charlene Troiani do Nascimento
- Department of Emergency, Regional Hospital of Presidente Prudente, Oeste Paulista University, São Paulo 19050-920, Brazil; (S.M.P.); (C.T.d.N.); (R.S.F.); (L.E.P.-C.)
| | - Rodrigo Sala Ferro
- Department of Emergency, Regional Hospital of Presidente Prudente, Oeste Paulista University, São Paulo 19050-920, Brazil; (S.M.P.); (C.T.d.N.); (R.S.F.); (L.E.P.-C.)
| | - Edilson Ferreira Flores
- Statistics Department, School of Sciences and Technology, São Paulo State University, Presidente Prudente 19060-900, Brazil;
| | | | - Elivelton da Silva Fonseca
- Institute of Geography, Santa Monica Campus, Federal University of Uberlandia, Uberlandia 38408-100, Brazil
| | - Luiz Euribel Prestes-Carneiro
- Department of Emergency, Regional Hospital of Presidente Prudente, Oeste Paulista University, São Paulo 19050-920, Brazil; (S.M.P.); (C.T.d.N.); (R.S.F.); (L.E.P.-C.)
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10
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Tsheten T, Clements ACA, Gray DJ, Adhikary RK, Wangdi K. Clinical features and outcomes of COVID-19 and dengue co-infection: a systematic review. BMC Infect Dis 2021; 21:729. [PMID: 34340682 PMCID: PMC8327042 DOI: 10.1186/s12879-021-06409-9] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 07/21/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Dengue is the most common arboviral disease in the tropical and sub-tropical regions of the world. Like other regions, dengue-endemic areas have faced the additional public health and socio-economic impact of the ongoing coronavirus disease 2019 (COVID-19) pandemic. COVID-19 and dengue co-infections have been reported, with complicated patient management and care requirements. This review aimed to collate and synthesise current knowledge on the clinical features and outcomes of COVID-19 and dengue virus co-infection, a potentially important new dimension to be considered in public health management of the COVID-19 pandemic. METHODS A systematic literature review was conducted using PubMed, Web of Science and Scopus databases from 1st January to 21st November 2020. The key search terms used were "dengue" and "coronavirus". Descriptive analysis with graphical illustrations were used to present the clinical and laboratory parameters of the co-infection. RESULTS Thirteen published papers and four news articles were included in the review. Most studies were case reports with a detailed description of the clinical and laboratory characteristics of the co-infection. All cases were in adults with the exception of a six-year old child. The common symptoms of co-infection were fever, dyspnea, headache, and cough. Common laboratory results included thrombocytopenia, lymphocytopenia, elevated transaminases, and leukopenia. Serious outcomes of co-infection included septic shock, acute respiratory disease syndrome and multi-organ failure, leading to death in some patients. CONCLUSIONS COVID-19 and dengue co-infection was associated with severe disease and fatal outcomes. The correct diagnosis and treatment of co-infection poses a substantial challenge due to the overlapping clinical and laboratory parameters. Therefore, confirmative diagnostic tests are necessary for accurate and timely diagnosis and patient management.
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Affiliation(s)
- Tsheten Tsheten
- Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, Australia
- Royal Centre for Disease Control, Ministry of Health, Thimphu, Bhutan
| | | | - Darren J. Gray
- Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, Australia
| | - Ripon K. Adhikary
- Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, Australia
| | - Kinley Wangdi
- Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, Australia
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11
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Cavany SM, España G, Vazquez-Prokopec GM, Scott TW, Perkins TA. Pandemic-associated mobility restrictions could cause increases in dengue virus transmission. PLoS Negl Trop Dis 2021; 15:e0009603. [PMID: 34370734 PMCID: PMC8375978 DOI: 10.1371/journal.pntd.0009603] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 08/19/2021] [Accepted: 06/28/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The 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. We sought to investigate how and why dengue incidence could differ under a lockdown scenario with a proportion of the population sheltered at home. METHODOLOGY & PRINCIPAL FINDINGS We used an agent-based model with a realistic treatment of human mobility and vector control. We found that a lockdown in which 70% of the population sheltered at home and which occurred in a season when a new serotype invaded could lead 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 higher 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. CONCLUSIONS & SIGNIFICANCE Our results indicate that an unintended outcome of lockdown 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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Affiliation(s)
- Sean M. Cavany
- Department of Biological Sciences, University of Notre Dame, Notre Dame, Indiana, United States of America
| | - Guido España
- Department of Biological Sciences, University of Notre Dame, Notre Dame, Indiana, United States of America
| | | | - Thomas W. Scott
- Department of Entomology and Nematology, University of California, Davis, Davis, California, United States of America
| | - T Alex Perkins
- Department of Biological Sciences, University of Notre Dame, Notre Dame, Indiana, United States of America
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Costa J, Ferreira EC, Santos C. COVID-19, Chikungunya, Dengue and Zika Diseases: An Analytical Platform Based on MALDI-TOF MS, IR Spectroscopy and RT-qPCR for Accurate Diagnosis and Accelerate Epidemics Control. Microorganisms 2021; 9:microorganisms9040708. [PMID: 33808104 PMCID: PMC8066533 DOI: 10.3390/microorganisms9040708] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 02/26/2021] [Accepted: 03/03/2021] [Indexed: 12/23/2022] Open
Abstract
COVID-19 and arboviruses (ARBOD) epidemics co-occurrence is a great concern. In tropical and subtropical regions, ARBOD diseases such as chikungunya, dengue, and Zika are frequent. In both COVID-19 and ARBOD cases, an accurate diagnosis of infected patients is crucial to promote adequate treatment and isolation measures in COVID-19 cases. Overlap of clinical symptoms and laboratory parameters between COVID-19 and ARBOD present themselves as an extra challenge during diagnosis. COVID-19 diagnosis is mainly performed by quantitative reverse polymerase chain reaction (RT-qPCR), while ARBOD diagnosis is performed by serology, detection of antigen or antibody, and molecular diagnosis. In this review, the epidemiologic profile of arboviruses and SARS-CoV-2 is analyzed, and potential risks of symptom overlap is addressed. The implementation of an analytical platform based on infrared (IR) spectroscopy, MALDI-TOF mass spectrometry, and RT-qPCR is discussed as an efficient strategy for a fast, robust, reliable, and cost-effective diagnosis system even during the co-occurrence of virus outbreaks. The spectral data of IR spectroscopy and MALDI-TOF MS obtained from COVID-19 infected and recovered patients can be used to build up an integrated spectral database. This approach can enable us to determine quickly the groups that have been exposed and have recovered from COVID-19 or ARBOD, avoiding misdiagnoses.
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Affiliation(s)
- Jéssica Costa
- Programa de Doctorado en Ciencias de Recursos Naturales, Universidad de La Frontera, Temuco 4811-230, Chile;
| | - Eugénio C. Ferreira
- CEB-Centre of Biological Engineering, Universidade do Minho, Campus of Gualtar, 4710-057 Braga, Portugal;
| | - Cledir Santos
- Department of Chemical Science and Natural Resources, Universidad de La Frontera, Temuco 4811-230, Chile
- Correspondence: ; Tel.: +56-45-259-6726
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Clinical and biochemical parameters of COVID-19 patients with prior or active dengue fever. Acta Trop 2021; 214:105782. [PMID: 33259817 PMCID: PMC7698682 DOI: 10.1016/j.actatropica.2020.105782] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 11/20/2020] [Accepted: 11/20/2020] [Indexed: 01/10/2023]
Abstract
Originated in Wuhan, China, the coronavirus 19 disease (COVID-19) has quickly spread worldwide, reaching countries that already faced other endemics and epidemics. In Brazil, such a concerning situation includes arboviruses, among which the dengue virus stands out. Here, we determined the rate of SARS-CoV-2/dengue virus co-infection in a total of 178 patients with COVID-19 symtoms admitted into a large public hospital of the Federal District of Brazil. Furthermore, we evaluated whether prior or active dengue virus infection influenced hematological, biochemical, and clinical parameters of such patients. One hundred and twelve (63%) individuals tested positive for COVID-19, of which 43 (38.4%) were co-infected with dengue virus, and 50 (44.6%) had antibodies indicative of previous dengue infection. Co-infected patients showed lower numbers of circulating lymphocytes and monocytes, higher glucose rates, and a worse pulmonary condition. Of note, prior infections with dengue virus did not influence clinical parameters, but active dengue fever resulted in higher hospitalization rate. In conclusion, amid the current complex epidemiological scenario in Brazil, our data support the notion that SARS-CoV-2 and dengue co-infection affects an important percentage of COVID-19 patients and leads to worse clinical parameters, requiring greater attention from health authorities.
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Coelho SVA, Rust NM, Vellasco L, Papa MP, Pereira ASG, da Silva Palazzo MF, Juliano MA, Costa SM, Alves AMB, Cordeiro MT, Marques ETA, Scharfstein J, de Arruda LB. Contact System Activation in Plasma from Dengue Patients Might Harness Endothelial Virus Replication through the Signaling of Bradykinin Receptors. Pharmaceuticals (Basel) 2021; 14:ph14010056. [PMID: 33445640 PMCID: PMC7827195 DOI: 10.3390/ph14010056] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 01/06/2021] [Indexed: 02/06/2023] Open
Abstract
Since exacerbated inflammation and microvascular leakage are hallmarks of dengue virus (DENV) infection, here we interrogated whether systemic activation of the contact/kallikrein-kinin system (KKS) might hamper endothelial function. In vitro assays showed that dextran sulfate, a potent contact activator, failed to generate appreciable levels of activated plasma kallikrein (PKa) in the large majority of samples from a dengue cohort (n = 70), irrespective of severity of clinical symptoms. Impaired formation of PKa in dengue-plasmas correlated with the presence of cleaved Factor XII and high molecular weight kininogen (HK), suggesting that the prothrombogenic contact system is frequently triggered during the course of infection. Using two pathogenic arboviruses, DENV or Zika virus (ZIKV), we then asked whether exogenous BK could influence the outcome of infection of human brain microvascular endothelial cells (HBMECs). Unlike the unresponsive phenotype of Zika-infected HBMECs, we found that BK, acting via B2R, vigorously stimulated DENV-2 replication by reverting nitric oxide-driven apoptosis of endothelial cells. Using the mouse model of cerebral dengue infection, we next demonstrated that B2R targeting by icatibant decreased viral load in brain tissues. In summary, our study suggests that contact/KKS activation followed by BK-induced enhancement of DENV replication in the endothelium may underlie microvascular pathology in dengue.
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Affiliation(s)
- Sharton V. A. Coelho
- Departamento de Virologia, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-902, Brazil; (S.V.A.C.); (N.M.R.); (M.P.P.); (A.S.G.P.)
| | - Naiara M. Rust
- Departamento de Virologia, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-902, Brazil; (S.V.A.C.); (N.M.R.); (M.P.P.); (A.S.G.P.)
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-902, Brazil; (L.V.); (M.F.d.S.P.)
| | - Lucas Vellasco
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-902, Brazil; (L.V.); (M.F.d.S.P.)
| | - Michelle P. Papa
- Departamento de Virologia, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-902, Brazil; (S.V.A.C.); (N.M.R.); (M.P.P.); (A.S.G.P.)
| | - Aline S. G. Pereira
- Departamento de Virologia, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-902, Brazil; (S.V.A.C.); (N.M.R.); (M.P.P.); (A.S.G.P.)
| | - Matheus Ferreira da Silva Palazzo
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-902, Brazil; (L.V.); (M.F.d.S.P.)
| | - Maria Aparecida Juliano
- Departamento de Biofísica, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo 04023-062, Brazil;
| | - Simone M. Costa
- Laboratório de Biotecnologia e Fisiologia de Infecções Virais, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro 21040-360, Brazil; (S.M.C.); (A.M.B.A.)
| | - Ada M. B. Alves
- Laboratório de Biotecnologia e Fisiologia de Infecções Virais, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro 21040-360, Brazil; (S.M.C.); (A.M.B.A.)
| | - Marli T. Cordeiro
- Fundação Oswaldo Cruz, Instituto Aggeu Magalhães, Recife 50740-465, Brazil; (M.T.C.); (E.T.A.M.)
| | - Ernesto T. A. Marques
- Fundação Oswaldo Cruz, Instituto Aggeu Magalhães, Recife 50740-465, Brazil; (M.T.C.); (E.T.A.M.)
- Department of Infectious Diseases, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Júlio Scharfstein
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-902, Brazil; (L.V.); (M.F.d.S.P.)
- Correspondence: (J.S.); (L.B.d.A.)
| | - Luciana B. de Arruda
- Departamento de Virologia, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-902, Brazil; (S.V.A.C.); (N.M.R.); (M.P.P.); (A.S.G.P.)
- Correspondence: (J.S.); (L.B.d.A.)
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