Dengue and COVID-19A Difference Emergence of Co-infection
Dengue and COVID-19 can cause similar symptoms at the early stages.
During the COVID-19 pandemic, healthcare providers in areas where dengue is
endemic or who are treating patients with a history of recent travel to these
areas should consider Dengue and COVID-19 in the differential diagnosis of
febrile illness. Most people with dengue and COVID-19 have a mild illness and
can be cured at home, the symptoms usually last a few days and people feel
better after a week. However, both dengue and COVID-19 can cause serious
illnesses that can lead to death.
Clinical treatment for people who develop serious illness with either of
these two conditions is quite different, often requiring hospital care. Anyone
of any age can develop a serious illness with dengue and COVID-19. Adults are
more likely to get complications by both infections with underlying chronic
conditions, such as diabetes and heart disease. Healthcare providers should
perform appropriate tests (for dengue and COVID-19 ) and closely monitor the
patient for warning signs.
Dengue warning signs include persistent vomiting, mucosal bleeding, and
shortness of breath, lethargy / restlessness, postural hypotension, liver
enlargement, and progressive increase in hematocrit. Warning signs of COVID-19
include shortness of breath, persistent chest pain or pressure, new confusion,
inability to wake up or stay awake, bluish lips or face. This list does not
include all probable symptoms. Complications can develop for both dengue and
COVID-19 before test results are obtained. Clinical management should be guided
by the clinical presentation.
Does social distancing from COVID-19 have the potential to
increase morbidity from dengue?
With the pandemic, people stay home and the risk of dengue infection may
increase as A. aegypti, the vector of the dengue virus, lays its eggs on the
walls of water-filled containers in and around the home. . Also, many people
are afraid to go to the hospital or consult healthcare professionals because
they fear that other patients or healthcare professionals have COVID-19. The
number of consultations has dropped considerably, partly because health
problems that are not urgent are being postponed, but perhaps because of this
fear of contamination. Furthermore, given the safety limitations related to
COVID-19, any feverish non-emergency patient must be examined and examined in a
special sector where great precautions are taken to avoid the risk of
transmission. Due to this great alteration in the organization of care, until
recently, only after receiving the results were more scans performed, which for
a time led to potentially dangerous diagnostic delays in dengue patients.
Dengue and COVID-19 symptoms
Dengue |
COVID-19 |
Dengue is caused by one of four related
viruses: dengue virus 1, 2, 3, and 4. For this reason, a person can become
infected with the dengue virus several times in their lifetime. |
COVID-19 or corona virus disease 2019 is a
respiratory illness caused by a coronavirus called SARS-CoV-2.
|
Dengue
and COVID-19 Transmission |
|
Dengue is mainly transmitted to people
through the bites of infected Aedes species mosquitoes (mainly Ae. Aegypti or
Ae. Albopictus species). |
COVID-19 is transmitted primarily from
person to person through respiratory droplets that are spread when an
infected person coughs, sneezes, or talks. |
Dengue and COVID-19 Incubation
period |
|
The incubation period for dengue varies
between 3 and 10 days, usually between 5 and 7 days. |
The incubation period for COVID-19 is
believed to extend to 14 days, with a median of 4-5 days from exposure to the
onset of symptoms. |
Dengue and COVID-19 Clinical manifestations |
|
dengue can range from mild to severe |
COVID-19 can range from mild to severe |
Dengue and COVID-19 Signs and Symptoms |
|
Mild
to moderate illness Febrile
phase Fever, Headache with eye pain, Myalgia, Nausea,
Vomiting, Rash. Leukopenia Warning signs of serious illness: abdominal
pain or tenderness, persistent vomiting, accumulation of clinical fluid,
mucosal bleeding, lethargy, restlessness, and liver enlargement. Critical
phase Warning signs may appear and rapid clinical
deterioration can occur within 48 hours after defervescence (3 to 7 days
after the onset of fever) |
Mild
to moderate illness Fever or chills, Cough, Shortness of breath
or shortness of breath, Loss of taste or smell , Muscle or body aches, Sore
throat, Fatigue, Headache, Stuffy or runny nose, Nausea or vomiting, Diarrhea
|
Dengue and COVID-19 Warning signs - seek medical attention |
|
Watch for severe dengue warning signs,
which usually start within 24-48 hours after the fever is gone. If you develop any of the following
symptoms, seek medical attention immediately: Abdominal pain, tenderness Vomiting (at least 3 times in 24 hours) The bleeding from the nose or gums Blood in Vomiting or stool Feeling tired, restless, or irritable. |
Looking for Emergency Warning Signs for
Covid-19. If anyone is showing any of these symptoms,
seek emergency medical attention immediately Breathing difficulty Frequent chest pain or pressure New confusion Wake up or inability to wake up Lips or face bluish These lists are not all possible symptoms.
Please call medical provider for any other symptoms that are serious to the
person. |
Dengue and COVID-19 Severe illness |
|
Dengue is defined as severe dengue with the
following symptoms and signs: Plasma leaks cause shock Fluid accumulation with respiratory
distress Severe bleeding with thrombocytopenia Severe organ weakness such as liver disease
with elevated transaminases, or meningoencephalitis with impaired
consciousness Patients with severe heart impairment
|
Among people who have developed severe
disease the median duration of dyspnea is 5 to 8 days, the median duration of
acute respiratory distress syndrome (ARDS) is 8 to 12 days, and the time for
ICU admission is from 10 to 12 days. Signs and symptoms of a serious illness may
include: Dyspnea Hypoxia Respiratory failure Shock Multi-organ system dysfunction One week after the onset of the disease,
clinicians should be aware of the possibility of rapid deterioration of some
patients. |
Dengue and COVID-19 Risk factors for severe illness |
|
Risk factors for severe dengue include: Age (Infant) Second dengue infection, In most
dengue-affected countries, children and young adults have the highest risk of
secondary infections. Patients with chronic medical conditions
including diabetes, asthma, or heart disease. |
Risk factors for severe illness with
COIVD-19 include: Age> 65 Underlying conditions such as Cardiovascular Disease,
Diabetes, Acute Respiratory Disease, Hypertension, Liver Disease, Obesity,
Lung Disease, Acute Kidney Disease, Dialysis, or Immuno-compromise (such as
Poorly Controlled HIV, undergoing Cancer treatment, Corticosteroids, smoking )
People who live in a nursing home or
long-term care facility |
Dengue and COVID-19 what you can do?
Communities and individuals should be well aware of both dengue and
COVID-19 and should be informed about prevention measures. With regard to
vector control, health promotion should encourage communities to seek potential
vector breeding sites and protect themselves from mosquito bites. Local
authorities must be very attentive and activate essential strategic services
for vector control (waste management, maintenance of public spaces,
intra-household interventions, especially around cases).
With regard to COVID-19, testing of suspected cases must be expanded (it
has been hampered by logistical limitations and insufficient supplies of swabs
and reagents), and the tracing and isolation of aggressive contacts must
continue. The diagnosis of febrile patients should be organized to allow the
diagnosis of both dengue and COVID 19 without delay due to the limitations of
COVID 19.
Hospitals, which have been radically reorganized to accommodate an
increase in COVID 19 patients, must plan beds for severe dengue cases. Patients
must stay under mosquito nets to avoid infecting other mosquitoes. Finally,
although specific syndromes have a good positive predictive value during a
single epidemic and do not always require biological confirmation, in this
case, due to co-circulation and the complicated collateral consequences,
diagnostic confirmation seems mandatory throughout the epidemic, which will use
more resources.
Sources