Case Report: Severe COVID-19 and Dengue in an Indonesian Infant

Alam, Anggraini; Sudarwati, Sri; Hakim, Dzulfikar Djalil Lukmanul; Mahdiani, Sally

doi:10.4269/ajtmh.20-1244

Cited by 5 publications

(2 citation statements)

References 14 publications

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“…The emergence of both dengue and COVID-19 infections have given rise to various cases of other co-infections. Several case reports from Indonesia and Thailand have shown misdiagnosis or delayed diagnosis, not only due to false-positive or false-negative interpretation, but also due to the "stigma" of COVID-19 diagnosis by the physicians themselves [13][14][15][16]. Misdiagnosis of COVID-19 as dengue also hinders isolation of patients leading to risk of airborne transmission to other patients.…”

Section: Challenges and Implicationsmentioning

confidence: 99%

Dengue and COVID-19 infections in the ASEAN region: a concurrent outbreak of viral diseases

Wiyono¹,

Rocha

Cedeño

et al. 2021

Epidemiol Health

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The countries of the Association of Southeast Asian Nations (ASEAN) have been dealing with dengue outbreaks for decades, being one of the regions with high dengue infection cases globally. These outbreaks are happening on top of the COVID-19 pandemic that is causing havoc among these ten countries. Both infectious diseases have caused a tremendous burden for the countries in the region-from infection control to the economic impact. This increasing number of cases happened with the contribution of the disruption in the pathogen-host-vector relationship, caused by the change of human behaviour during the pandemic period, and aggravated by the implementation of lockdowns and social distancing policies. These had several consequences, including limiting the coverage of dengue preventive programs and delaying the medical management of both diseases due to co-infection and misdiagnosis. It is of utmost importance to maintain the awareness of the population of both diseases and to devise strategies on dengue vector control to properly address the infection with digitalization and remote surveillance.Similarly, critical triage algorithms and further research are also needed to address co-infection and misdiagnosis. Management of COVID-19 using vaccination also should be optimized to subside the pandemic.

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Section: Challenges and Implicationsmentioning

confidence: 99%

Dengue and COVID-19 infections in the ASEAN region: a concurrent outbreak of viral diseases

Wiyono¹,

Rocha

Cedeño

et al. 2021

Epidemiol Health

View full text Add to dashboard Cite

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“…We report a SARS-CoV-2 and DENV co-infection that occurred in April 2020, at the beginning of the pandemic in Indonesia. Since then, several additional co-infections have been recognized (13,14). Our patient's clinical manifestations were moderate despite having dual DENV and SARS-CoV-2 infections on the backdrop of DM type II.…”

Section: Discussionmentioning

confidence: 73%

Coinfection With SARS-CoV-2 and Dengue Virus: A Case Report Highlighting Diagnostic Challenges

Hariadi

Lokida

Naysilla³

et al. 2022

Front. Trop. Dis

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BackgroundSince its emergence in China, SARS-CoV-2 has infected more than 240 million people worldwide, including in regions where dengue virus (DENV) is hyperendemic such as Latin America and Southeast Asia, including Indonesia. Diagnosis of COVID-19 in dengue endemic regions as well as DENV and SARS-CoV-2 co-infection can be challenging.Case PresentationWe describe a 68-year-old woman with diabetes mellitus type II who was admitted to the Tangerang District Hospital on 14 April 2020. She lived in a neighborhood where a few people were contracting dengue fever. She presented with five days of fever, malaise, anorexia, nausea, myalgia, and arthralgia. Hematology revealed anemia, thrombocytopenia, normal leukocyte count, increased neutrophil proportion, and decreased lymphocyte proportion and absolute lymphocytes. Her chest X-ray showed right pericardial infiltrates. Although dengue was clinically suspected, she was also tested for SARS-CoV-2 infection as she met screening criteria. After being confirmed SARS-CoV-2 positive by RT-PCR, she was treated with ceftriaxone, paracetamol, azithromycin, oseltamivir, and chloroquine. She was clinically improved four days later and discharged from the hospital on 25 April 2020 after SARS-CoV-2 RT-PCR was negative on two consecutive samples. Dengue was diagnosed retrospectively based on sero-conversion of dengue IgM and a very high dengue IgG index (ELISA, Focus Diagnostics®, Cypress, CA, USA), and sero-conversion of dengue IgM and positive IgG (Rapid test, PanBio ®Dengue duo cassette, Inverness Medical Innovations, QLD, AU), which was equivalent to high Hemagglutination Inhibition (HI) antibody titer (≥1280) found in secondary dengue infection.ConclusionThe overlapping clinical presentations of COVID-19 and dengue; limited diagnostic capacity of laboratories in resource constrained settings; and complexities of interpreting results make identification of COVID-19 in the dengue endemic setting challenging. Clinicians in endemic areas must be aware of diagnostic challenges and maintain a high index of suspicion for COVID-19 coinfection with DENV and other tropical pathogens.

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