tetano
Editor, Senior Moderator
Int J Infect Dis
. 2020 Oct 25;S1201-9712(20)32248-7.
doi: 10.1016/j.ijid.2020.10.043. Online ahead of print.
Serological cross-reaction and co-infection of dengue and COVID-19 in Asia: Experience from Indonesia
Sri Masyeni[SUP] 1 [/SUP], Marsha S Santoso[SUP] 2 [/SUP], Putu Dyah Widyaningsih[SUP] 3 [/SUP], D G Wedha Asmara[SUP] 4 [/SUP], Firzan Nainu[SUP] 5 [/SUP], Harapan Harapan[SUP] 6 [/SUP], R Tedjo Sasmono[SUP] 7 [/SUP]
Affiliations
Abstract
Similar symptoms and laboratory findings between dengue and coronavirus disease 2019 (COVID-19) pose a diagnostic challenge in some dengue-endemic countries in Asia. In this study, we reported three cases of suspected COVID-19-dengue co-infection in hospitals of Bali, Indonesia. Serological data demonstrated that patients with positive results on dengue virus (DENV) NS1 antigen and anti-dengue IgM were also reactive to COVID-19 rapid antibody tests, suggesting dengue-COVID-19 co-infection. However, two patients were later confirmed negative for SARS-CoV-2 by qRT-PCR, implying a plausible cross-reactivity of anti-dengue and anti-COVID-19 antibodies in the serological test. Co-infection of dengue and COVID-19 was evident in one patient, following confirmation of SARS-CoV-2 by qRT-PCR and DENV infection using NS1 antigen serology test. This case was the first case of dengue and COVID-19 co-infection in Indonesia and at the same time revealed possible cross-reactivity between SARS-CoV-2 and DENV antibodies based on rapid serological tests. Our study shall raise public health concern for COVID-19 and dengue detection in Indonesia as well as in other dengue-endemic countries as it may present a tip of the dangerous iceberg for the nations' effort to manage of both pathogens.
Keywords: Co-infection; Cross-reactivity; Dengue; Misdiagnosis; Mixed-infection.
. 2020 Oct 25;S1201-9712(20)32248-7.
doi: 10.1016/j.ijid.2020.10.043. Online ahead of print.
Serological cross-reaction and co-infection of dengue and COVID-19 in Asia: Experience from Indonesia
Sri Masyeni[SUP] 1 [/SUP], Marsha S Santoso[SUP] 2 [/SUP], Putu Dyah Widyaningsih[SUP] 3 [/SUP], D G Wedha Asmara[SUP] 4 [/SUP], Firzan Nainu[SUP] 5 [/SUP], Harapan Harapan[SUP] 6 [/SUP], R Tedjo Sasmono[SUP] 7 [/SUP]
Affiliations
- PMID: 33115680
- DOI: 10.1016/j.ijid.2020.10.043
Abstract
Similar symptoms and laboratory findings between dengue and coronavirus disease 2019 (COVID-19) pose a diagnostic challenge in some dengue-endemic countries in Asia. In this study, we reported three cases of suspected COVID-19-dengue co-infection in hospitals of Bali, Indonesia. Serological data demonstrated that patients with positive results on dengue virus (DENV) NS1 antigen and anti-dengue IgM were also reactive to COVID-19 rapid antibody tests, suggesting dengue-COVID-19 co-infection. However, two patients were later confirmed negative for SARS-CoV-2 by qRT-PCR, implying a plausible cross-reactivity of anti-dengue and anti-COVID-19 antibodies in the serological test. Co-infection of dengue and COVID-19 was evident in one patient, following confirmation of SARS-CoV-2 by qRT-PCR and DENV infection using NS1 antigen serology test. This case was the first case of dengue and COVID-19 co-infection in Indonesia and at the same time revealed possible cross-reactivity between SARS-CoV-2 and DENV antibodies based on rapid serological tests. Our study shall raise public health concern for COVID-19 and dengue detection in Indonesia as well as in other dengue-endemic countries as it may present a tip of the dangerous iceberg for the nations' effort to manage of both pathogens.
Keywords: Co-infection; Cross-reactivity; Dengue; Misdiagnosis; Mixed-infection.