We describe the cases of two patients with fever initially diagnosed as dengue and urinary tract infection. The patients were inmates of the same prison and were in contact with stagnant drinking water, which is considered to be the likely site of contamination, about 2 weeks before the onset of the symptoms during the carnival celebrations. The time between the hospital admission and suspected leptospirosis (and starting specific treatment) was four days for the patient in case 1 and two days for case 2; between admission and laboratory diagnostic confirmation was ten days for case 1 and four days for case 2. We conclude that Leptospirosis is not considered as an option in the initial differential diagnosis but only after ruling out other pathologies.

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The World Health Organization (WHO) defines health as the state of perfect (complete) physical, mental and social well-being, and not just the absence of disease. In epidemic and pandemic situations, such as the COVID-19 pandemic that we are currently going through, all these spheres, physical, mental, and social, are affected, which threatens the lives of many people and significantly increases the number of sick and deceased people. The general fear of contagion worsens the existing situation and leads to a psychosocial impact that will, at some point, exceed the ability of health personnel to confront and manage the affected population. It is considered that the increase in the incidence of mental disorders and emotional manifestations is directly related to the magnitude of the epidemic and the level of vulnerability of the country affected. However, not all of the mental problems that occur can be classified as a mental health disorder, as many of these are normal reactions to an abnormal situation.

If we remember very superficially a little about the complex human immune system, a part of this immune system is made up of leukocytes (especially phagocytes and lymphocytes) that are responsible for detecting invaders and sending them defensive markers that adhere to them (the antibodies) and also to destroy the invaders identified by the system; In addition to the already mentioned leukocytes, our immune system is made up of various other elements such as cells, proteins, tissues and organs, which defend us against germs and microorganisms. 1, 2 Speaking specifically about the immune system and COVID-19, the events mainly involved in the immunopathogenesis of COVID-19 and the dysregulation of the immune response include lymphopenia and increased neutrophil-to-lymphocyte ratio, cytokines, lymphocyte depletion and dysfunction, antibody-dependent enhancement, and monocyte and granulocyte abnormalities. It must be emphasized that lymphopenia is an essential finding in most patients with COVID-19, particularly in those with a severe phenotype.3 It has been shown that multiple viral proteins induce T cells after infection and that T cells that have antiviral signatures related to safety and protection can be achieved by vaccination.4

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