Cases of COVID-19, dengue co-infection rising: doctors

Combination could enhance severity of both diseases

Delhi is registering a rise in co-infection of dengue and COVID-19 with doctors now warning that this combination could enhance the severity of both diseases.

“Most cases of COVID-19 and dengue are asymptomatic (about 80%), and in a setting of co-infection one disease might enhance the severity of the other,” Ashutosh Biswas, professor of Medicine at AIIMS-Delhi, told The Hindu.

False positives

He further noted that false positivity is high among co-infection cases, which can create diagnostic challenges.

Delhi is currently registering a spike in both dengue and COVID-19 cases as per official health department data. “Both the viral diseases do not have any specific antiviral drug or vaccine and therefore treatment depends on clinical conditions and symptoms,” he added.

AIIMS authorities said 53 dengue cases have been admitted to the hospital so far this year, out of which 42 were reported during the ongoing pandemic. “Emergence of co-infection of COVID-19 and dengue is expected to be a serious public health challenge. Rising dengue cases will create more pressure on an already overburdened health system,” said doctors.

It is also difficult to distinguish symptoms of the two diseases due to overlapping initial clinical presentations and laboratory parameters. “Both COVID-19 and dengue have unpredictable clinical courses and both generally require hospital monitoring for management. Most hospitals are busy managing COVID-19 and very little window is open for tackling another disease outbreak. IV Fluid therapy is challenging in co-infected patients due to early development of ARDS/pulmonary oedema, and treatment with low molecular weight heparin for management of COVID-19 may enhance bleeding in the presence of dengue, especially with low platelet count,” said Dr. Biswas.

Doctors added that besides diagnostic and treatment challenges there is “limited experience” in tackling such situation and the “paucity of medical literature on management of such co-infection cases has kept everyone in dark”.

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