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Vol - 29, Issue - 02
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[This article belongs to Volume - 29, Issue - 02]
International Medical Journal
Journal ID
:
IMJ-20-01-2022-1206
Total View
:
463
Title
:
DENGUE SEROLOGY IN COVID-19 PATIENTS IN A DENGUE ENDEMIC AREA, IS IT A COINFECTION OR A SEROLOGICAL OVERLAP?
Abstract
: Dengue, a viral infection is caused by the DENV virus, is a major public health concern in Asian countries including India, with manifestations ranging from mild dengue fever (DF) to severe and life-threatening dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS)1. Physicians mostly depend on serological tests to confirm dengue and the newly disseminated serological test kit, to diagnose COVID-19, but there seems to be a serological overlap between the two diseases. 1. To identify the cases of dengue and Covid-19 co-infection 2. To determine if there is a serological cross-reactivity between dengue fever and Covid-19 3. To prevent initial misdiagnosis which might cause a change in treatment plan and significant losses. The present study is an observational study conducted among 104 Covid-19 positive cases with dengue like symptoms admitted to SRM Medical College and Hospital and Research Centre, Potheri for a period of 6 months. Dengue Elisa test for Ns1, IgM, IgG, will be tested in Covid-19 positive patients with dengue like symptoms. In the patients with positive dengue Elisa test, Dengue [RT-PCR] is done to see whether initial results are false positive or co-infection. Out of 104 Covid-19 positive patients included in our study more individuals are found to be >61 years old. And out of 104 participants, 64 are male and 40 are female. We performed dengue Elisa on all the participants who are Covid-19 positive to rule out possible dengue coinfection. Ns1 antigen for dengue was negative in all, while IgM Elisa was found to be positive in 41 (39%) patients which is suggestive of acute dengue coinfection. 3 (3%) patients had positive dengue IgG Elisa results, out of them two had Ns1, IgM negative and one had both IgG, IgM positive. All three had no past history of dengue infection. To confirm whether the dengue IgM positive results are due to coinfection or antibody cross-reactivity, we further proceeded with dengue RTPCR which is a gold standard test for confirmation. Interestingly, all IgM positive patients were tested negative for dengue RTPCR. Hence, it can therefore be assumed that the dengue IgM, IgG positive results in Covid-19 infected individuals are due to antibody cross-reactivity and not a coinfection. Failing to consider COVID-19 because of a positive dengue test result has serious implications not only for the patient but also for public health. As a result, it's time to emphasize the importance of recognizing false-positive dengue serology results in patients with COVID-19.
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