Diagnosis of COVID-19 in a Dengue-Endemic Area

Abstract

. Emergence of SARS-CoV-2 in dengue virus (DENV)–endemic areas complicates the diagnosis of both infections. COVID-19 cases may be misdiagnosed as dengue, particularly when relying on DENV IgM, which can remain positive months after infection. To estimate the extent of this problem, we evaluated sera from 42 confirmed COVID-19 patients for evidence of DENV infection. No cases of SARS-CoV-2 and DENV coinfection were identified. However, recent DENV infection, indicated by the presence of DENV IgM and/or high level of IgG antibodies, was found in seven patients. Dengue virus IgM and/or high IgG titer should not exclude COVID-19. SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) testing is appropriate when dengue nonstructural protein 1 (NS1) or RT-PCR is negative. Given the possibility of coinfection, testing for both DENV and SARS-CoV-2 is merited in the setting of the current pandemic.

Clinicopathologic correlations of COVID-19–related cutaneous manifestations with special emphasis on histopathologic patterns

“…Of the 84 contributions accepted for our analysis, 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14. , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , ...…”

“…Differential with dengue fever is an emergent problem in tropical countries, where both diseases are prevalent. 70 , 71 , 72 Bacterial infections have been suspected to co-associate with COVID-19, especially Mycoplasma pneumoniae, which may trigger erythema multiforme. 84 The main differential diagnosis involves adverse drug reactions 85 , 86 whose histopathology includes a wide range of microscopic patterns, 87 from spongiotic or perivascular mixed infiltrate to interface dermatitis or vasculitis.…”

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

“…Another hypothesis is that cross-reactivity among DENV and SARS-CoV-2, which may be related to tandem virus infection, can lead to false-positive dengue serology [ 17 , 18 , 98 , 99 , 101 , 102 , 103 , 104 , 105 ]. Both hypotheses are feasible and require more comprehensive cohort studies.…”

“…Concomitantly, dengue reaches its peak in the first quarter of the year in Manaus and other municipalities in northern Brazil that are currently also classified as purple and red for COVID-19 [97]. Other geographical regions such as India, Thailand, and Singapore faced this overlap of COVID-19/ARBOD infections between September and November 2020 [98].…”

Year 100 of the American Journal of Tropical Medicine and Hygiene: A Remarkable Year

“…Although most attention in the United States has gone to COVID-19 in highly developed countries, which have been particularly hard-hit, the pandemic has also spurred the provision of advanced medical care in many low-and lowmiddle-income countries that typically offer such care on a very limited basis. Availability of advanced care has certainly been spotty, but we can hope that various COVID-19-inspired advances, from efficient diagnostics 17,24,25 to point-of-care ultrasound [26][27][28][29][30] and relatively low-cost means of mechanical ventilation, 31,32 will remain in less developed countries as the pandemic disappears. Evaluation of the utilization of new technologies for the care of tropical diseases is a major focus of the AJTMH, and so advances facilitated by the pandemic will be featured.…”