Dengue and COVID-19 A Difference Emergence of Co-infection ~ Nursing Guru

Dengue and COVID-19 A Difference Emergence of Co-infection

 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 and COVID-19A Difference Emergence of Co-infection

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 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:



Respiratory failure


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.



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