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. 2021 Jul 31;21(1):727.
doi: 10.1186/s12879-021-06456-2.

SARS-CoV-2/DENV co-infection: a series of cases from the Federal District, Midwestern Brazil

Heidi Luise Schulte  1 , José Diego Brito-Sousa  2   3 , Marcus Vinicius Guimarães Lacerda  2   4 , Luciana Ansaneli Naves  5 , Eliana Teles de Gois  1   6 , Mariana Sirimarco Fernandes  5   7 , Valéria Paes Lima  1   8 , Carlos Henrique Reis Esselin Rassi  1   8 , Clara Correia de Siracusa  5 , Lizandra Moura Paravidine Sasaki  1   5 , Selma Regina Penha Silva Cerqueira  5 , Cleandro Pires de Albuquerque  1   5 , Ana Paula Monteiro Gomides Reis  9 , Ciro Martins Gomes  1   5   10 , Patricia Shu Kurizky  1   5 , Licia Maria Henrique da Mota  1   5 , Laila Salmen Espindola  11
Affiliations

SARS-CoV-2/DENV co-infection: a series of cases from the Federal District, Midwestern Brazil

Heidi Luise Schulte et al. BMC Infect Dis. .

Abstract

Background: Since the novel coronavirus disease outbreak, over 179.7 million people have been infected by SARS-CoV-2 worldwide, including the population living in dengue-endemic regions, particularly Latin America and Southeast Asia, raising concern about the impact of possible co-infections.

Methods: Thirteen SARS-CoV-2/DENV co-infection cases reported in Midwestern Brazil between April and September of 2020 are described. Information was gathered from hospital medical records regarding the most relevant clinical and laboratory findings, diagnostic process, therapeutic interventions, together with clinician-assessed outcomes and follow-up.

Results: Of the 13 cases, seven patients presented Acute Undifferentiated Febrile Syndrome and six had pre-existing co-morbidities, such as diabetes, hypertension and hypopituitarism. Two patients were pregnant. The most common symptoms and clinical signs reported at first evaluation were myalgia, fever and dyspnea. In six cases, the initial diagnosis was dengue fever, which delayed the diagnosis of concomitant infections. The most frequently applied therapeutic interventions were antibiotics and analgesics. In total, four patients were hospitalized. None of them were transferred to the intensive care unit or died. Clinical improvement was verified in all patients after a maximum of 21 days.

Conclusions: The cases reported here highlight the challenges in differential diagnosis and the importance of considering concomitant infections, especially to improve clinical management and possible prevention measures. Failure to consider a SARS-CoV-2/DENV co-infection may impact both individual and community levels, especially in endemic areas.

Keywords: COVID-19; Case series; Co-infection; DENV; Dengue; SARS-CoV-2.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Signs and symptoms described in hospital medical records at the first evaluation of patients with SARS-CoV-2/DENV co-infection
Fig. 2
Fig. 2
Timeline presenting the initial diagnosis established in the 13 SARS-CoV-2/DENV co-infection cases reported by the Hospital Universitário de Brasília since the beginning of the COVID-19 pandemic in Brazil. The x-axis divisions represent weeks. Background lines represent the epidemic curves for dengue fever (blue line) and COVID-19 (red line), based on official reports from the Brazilian Ministry of Health [7, 12]
See this image and copyright information in PMC

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