Potential Misdiagnosis between COVID-19 and Dengue Infection Using Rapid Serological Test

Khairunisa, Siti Qamariyah; Amarullah, Ilham Harlan; Churrotin, Siti; Fitria, Anisa Lailatul; Amin, Mochamad; Lusida, Maria Inge; Soegijanto, Soegeng

doi:10.3390/idr13020050

Cited by 21 publications

(21 citation statements)

References 27 publications

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“…Furthermore, due to the wide array of disease indications and the absence of clear case definitions between COVID-19 and dengue, many instances of dengue went unreported. The clinical presentation of both the diseases are similar in symptoms like fever, muscle or body ache, nausea, vomiting, and others leading to a high possibility for misdiagnosis [ 13 ]. Furthermore, in individuals who present with co-infection with both dengue and COVID-19 at the same time, it may result in death or leave the patient in a vulnerable health situation.…”

Section: Challenges and Effortsmentioning

confidence: 99%

Devastating dengue outbreak amidst COVID-19 pandemic in Bangladesh: an alarming situation

et al. 2022

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Dengue fever is a viral infection caused by Aedes mosquitoes that has recently expanded fast in many of the WHO member states globally. Female mosquitoes, mostly Aedes aegypti and, to a smaller degree, Aedes albopictus, disseminate dengue virus. Dengue fever has been more common in recent decades all across the world, and Bangladesh is no exception. As the COVID-19 outbreak wreaks havoc, the following rise in dengue illnesses has been a source of considerable concern. As the health care has been stretched thin in these dangerous times, the vulnerable population has been left at the mercy of these two viral infections. Lack of knowledge, major legislative changes, poor eradication initiatives, and a lack of financing resources have all contributed to the increase in numbers. Stakeholders and policymakers must begin taking meaningful actions and implementing well-thought-out adjustments immediately, or the situation will worsen, resulting in the loss of thousands of innocent lives.

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Section: Challenges and Effortsmentioning

confidence: 99%

Devastating dengue outbreak amidst COVID-19 pandemic in Bangladesh: an alarming situation

et al. 2022

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“…Such cross-reactions were expected, in line with the recent demonstration of shared antigenic similarity between DENV and SARS-CoV-2, resulting in cross-reactivity of the antibody response to both viruses [36][37][38][39][40][41][42][43]. Cross-reactivity of antibodies against DENV and SARS-CoV-2 was shown to be especially high using rapid diagnostic tests (RDT), as opposed to ELISA [36,[38][39][40][41][42][43]. This might explain the relatively low cross-reactivity rates with SARS-CoV-2 samples observed in this study using the VIDAS ® Anti-DENV IgM and IgG assays.…”

Section: Discussionmentioning

confidence: 68%

“…Cross-reactivity with samples from SARS-CoV-2-infected patients (2/16 [12.5%] for IgM and 1/20 [5.0%] for IgG) was also observed. Such cross-reactions were expected, in line with the recent demonstration of shared antigenic similarity between DENV and SARS-CoV-2, resulting in cross-reactivity of the antibody response to both viruses [36–43]. Cross-reactivity of antibodies against DENV and SARS-CoV-2 was shown to be especially high using rapid diagnostic tests (RDT), as opposed to ELISA [36,38–43].…”

Section: Discussionmentioning

confidence: 82%

“…Notably, cross-reactivity of the VIDAS ® Anti-DENGUE IgM and IgG assays with West Nile Virus (WNV)positive samples was lower than that reported by the competitor IgM and IgG ELISA manufacturers ( [5.0%] for IgG) was also observed. Such cross-reactions were expected, in line with the recent demonstration of shared antigenic similarity between DENV and SARS-CoV-2, resulting in cross-reactivity of the antibody response to both viruses [36][37][38][39][40][41][42][43]. Cross-reactivity of antibodies against DENV and SARS-CoV-2 was shown to be especially high using rapid diagnostic tests (RDT), as opposed to ELISA [36,[38][39][40][41][42][43].…”

Section: Discussionmentioning

confidence: 86%

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Performance of VIDAS® Diagnostic Tests for the Automated Detection of Dengue Virus NS1 Antigen and of Anti-Dengue Virus IgM and IgG Antibodies: a Multicentre, International Study

Versiani

Kaboré

Brossault

et al. 2022

Preprint

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Dengue is a serious mosquito-transmitted disease caused by the dengue virus (DENV). Rapid and reliable diagnosis of DENV infection is urgently needed in dengue-endemic regions. We describe here the performance evaluation of the CE-marked VIDAS dengue immunoassays developed for the automated detection of DENV NS1 antigen, and anti-DENV IgM and IgG antibodies. A multicenter concordance study was conducted in 1296 patients from dengue-endemic regions in Asia, Latin America, and Africa. VIDAS dengue results were compared to those of competitor enzyme-linked immunosorbent assays (ELISA). The VIDAS dengue assays showed high precision (CV equal or below 10.7%) and limited cross-reactivity (equal or below 15.4%) with other infections. VIDAS DENGUE NS1 Ag showed high positive and negative percent agreement (92.8% PPA, 91.7% NPA) in acute patients within 0-5 days of symptom onset. VIDAS Anti-DENGUE IgM and IgG showed a moderate to high concordance with ELISA (74.8% to 90.6%) in post-acute and recovery patients. PPA was further improved in combined VIDAS NS1/IgM (96.4% in 0-5 days acute patients) and IgM/IgG (91.9% in post-acute patients) tests. Altogether, the VIDAS dengue NS1, IgM and IgG assays performed well, either alone or in combination, and should be suitable for the accurate diagnosis of DENV infection in dengue-endemic regions.

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“…Dengue NS1 and IgM/IgG RDTs are useful in the emergency room to guide clinicians. However, several studies in Indonesia have reported detection of dengue antibodies in confirmed COVID-19 patients (13,21,23,31), and cross-reactivity between DENV and COVID-19 antibody RDTs has been suggested based on similarities between epitopes in the HR2 domain of the SARS-CoV-2 spike protein and the dengue envelope protein from insilico analysis, though false positives and alternate antigen crossreactivity cannot be ruled out (32). Cross-reactivity between Covid-19 antibodies and other co-circulating infections is also possible (33).…”

Section: Discussionmentioning

confidence: 99%

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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Potential Misdiagnosis between COVID-19 and Dengue Infection Using Rapid Serological Test

Cited by 21 publications

References 27 publications

Devastating dengue outbreak amidst COVID-19 pandemic in Bangladesh: an alarming situation

Devastating dengue outbreak amidst COVID-19 pandemic in Bangladesh: an alarming situation

Performance of VIDAS® Diagnostic Tests for the Automated Detection of Dengue Virus NS1 Antigen and of Anti-Dengue Virus IgM and IgG Antibodies: a Multicentre, International Study

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

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