Abstract
BackgroundSince the novel coronavirus disease outbreak, over 179.7 million people have been infected by SARS-CoV-2 worldwide, including the population living in dengue-endemic regions, particularly Latin America and Southeast Asia, raising concern about the impact of possible co-infections.MethodsThirteen SARS-CoV-2/DENV co-infection cases reported in Midwestern Brazil between April and September of 2020 are described. Information was gathered from hospital medical records regarding the most relevant clinical and laboratory findings, diagnostic process, therapeutic interventions, together with clinician-assessed outcomes and follow-up.ResultsOf the 13 cases, seven patients presented Acute Undifferentiated Febrile Syndrome and six had pre-existing co-morbidities, such as diabetes, hypertension and hypopituitarism. Two patients were pregnant. The most common symptoms and clinical signs reported at first evaluation were myalgia, fever and dyspnea. In six cases, the initial diagnosis was dengue fever, which delayed the diagnosis of concomitant infections. The most frequently applied therapeutic interventions were antibiotics and analgesics. In total, four patients were hospitalized. None of them were transferred to the intensive care unit or died. Clinical improvement was verified in all patients after a maximum of 21 days.ConclusionsThe cases reported here highlight the challenges in differential diagnosis and the importance of considering concomitant infections, especially to improve clinical management and possible prevention measures. Failure to consider a SARS-CoV-2/DENV co-infection may impact both individual and community levels, especially in endemic areas.
Highlights
Since the novel coronavirus disease outbreak, over 179.7 million people have been infected by SARSCoV-2 worldwide, including the population living in dengue-endemic regions, Latin America and Southeast Asia, raising concern about the impact of possible co-infections
We describe a series of 13 patients with a SARS-CoV-2/dengue viruses (DENV) co-infection in Brazil aiming to disclose important details of this emerging co-infection considering the diagnosis, clinical management and possible prevention measures. This retrospective study evaluated 13 patients coinfected with SARS-CoV-2 and DENV diagnosed at the Hospital Universitário de Brasília (HUB), a university hospital located in Brasília (Federal District, Brazil), between April and September of 2020
All patients included in this study: (a) had positive reverse transcriptase-polymerase chain reaction (RT-PCR) for SARS-CoV-2, and a positive Non-structural protein 1 (NS1) or Immunoglobulin M (IgM) enzyme-linked immunosorbent assay (ELISA) for DENV with strongly suggestive dengue symptoms in a maximum timeframe of 15 days (RT-PCR for DENV was not performed for any of the patients); (b) resided in the Federal District; (c) were over 18 years old, and (d) were able to understand the information contained in the Free and Informed Consent Form
Summary
Since the novel coronavirus disease outbreak, over 179.7 million people have been infected by SARSCoV-2 worldwide, including the population living in dengue-endemic regions, Latin America and Southeast Asia, raising concern about the impact of possible co-infections. Since the outbreak of the novel coronavirus disease (COVID-19), over 179.7 million people have been infected by SARS-CoV-2 in over 210 countries [1]. This includes developing regions that are endemic for dengue fever, Latin America and Southeast Asia, which raised concern about the effects of co-infection with dengue viruses (DENV) and SARS-CoV-2 [2,3,4,5,6]. Due to similarities in their epidemiological and clinical profiles, co-infections of DENV with other febrile syndromes have been reported [9, 10]
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