Impact of Recent SARS-CoV-2 Infection on the Course and Severity of Dengue in Children: A Prospective Observational Study from North India

In 2020, a considerable overlap occurred between the COVID-19 pandemic and seasonal dengue transmission in India. This study aimed to evaluate the effects of acute or recent infection with SARS-CoV-2 on the course and outcomes of dengue fever in children. We prospectively enrolled 44 children with a...

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Published in:The American journal of tropical medicine and hygiene Vol. 105; no. 3; pp. 751 - 755
Main Authors: Ravikumar, Namita, Randhawa, Manjinder Singh, Nallasamy, Karthi, Angurana, Suresh Kumar, Kumar, Mahendra, Mohi, Gursimran Kaur, Ratho, Radha Kanta, Jayashree, Muralidharan
Format: Journal Article
Language:English
Published: United States Institute of Tropical Medicine 01-09-2021
The American Society of Tropical Medicine and Hygiene
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Summary:In 2020, a considerable overlap occurred between the COVID-19 pandemic and seasonal dengue transmission in India. This study aimed to evaluate the effects of acute or recent infection with SARS-CoV-2 on the course and outcomes of dengue fever in children. We prospectively enrolled 44 children with a clinical and laboratory diagnosis of dengue fever. Assessment of acute and recent SARS-CoV-2 infection was done using reverse transcription-polymerase chain reaction and IgG antibody through ELISA. Children were grouped based on evidence of SARS-CoV-2 exposure and clinical severity, and outcomes were compared. The median age of the study cohort was 96 months (interquartile range [IQR]: 69-129 months). Fever (98%), vomiting (78%), abdominal pain (68%), hepatomegaly (68%), and edema (32%) were the common features. About two-thirds (N = 30) had severe dengue; 20 (45%) had dengue shock. Liver dysfunction (58%) and acute kidney injury (25%) were other major organ dysfunctions. Nineteen (43%) children stayed in the pediatric intensive care unit for a median duration of 5 days (IQR: 2-11 days). None had acute SARS-CoV2 infection; however, IgG against SARS-CoV-2 was detected in 15 (34%) cases. Children with recent exposure to SARS-CoV-2 showed a trend toward a lower incidence of acute kidney injury, fewer organ dysfunctions, and a lower frequency of invasive ventilation. Four children (9%) died; none of the deaths were in the SARS-CoV-2-exposed group. The present study exposes preliminary evidence that dengue fever might follow a less severe course in children with recent exposure to SARS-CoV-2 infection. However, it is pertinent to understand the antigenic similarity and cross-protective antibody response between the two viruses and their clinical relevance.
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These authors contributed equally to this work.
Authors’ addresses: Namita Ravikumar, Pediatric Intensive Care and Pulmonology Units, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India, E-mail: namitu.ravi@gmail.com. Manjinder Singh Randhawa, Karthi Nallasamy, Suresh Kumar Angurana, and Muralidharan Jayashree, Division of Pediatric Critical Care, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India, E-mails: randhawams192@gmail.com, ny.karthi@gmail.com, sureshangurana@gmail.com, and mjshree@hotmail.com. Mahendra Kumar, Department of Immunopathology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India, E-mail: drbindmahendra@gmail.com. Gursimran Kaur Mohi and Radha Kanta Ratho, Department of Virology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India, E-mails: gkmohi@gmail.com and rathopgi@yahoo.com.
ISSN:0002-9637
1476-1645
1476-1645
DOI:10.4269/ajtmh.21-0586