Abstract
The simultaneous occurrence of outbreaks of dengue fever and Coronavirus Disease 2019 (COVID-19) has arisen as a significant worldwide public health challenge, particularly in tropical and subtropical areas where dengue is endemic and healthcare systems are still vulnerable. Co-epidemics of dengue virus (DENV) and Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) pose important clinical, diagnostic and epidemiological issues due to overlapping symptoms, identical laboratory findings and concurrent transmission of both diseases. This review summarises the existing knowledge on the epidemiology, clinical symptoms, laboratory diagnosis, immunopathogenesis and public health implications of dengue and COVID-19 co-infections. Both disorders appear with fever, headache, myalgia, thrombocytopenia, leukopenia and raised inflammatory markers making it difficult to differentiate them at an early stage. Coinfected individuals may suffer severe consequences such as cytokine storm, respiratory distress, plasma leakage, coagulopathy, multiorgan failure and increased mortality. Serological crossreactivity between DENV and SARS-CoV-2 antibodies adds to diagnostic confusion, leading to false-positive laboratory results and delayed treatment. Molecular diagnostic procedures such as reverse transcription-polymerase chain reaction (RT-PCR) are still needed for precise confirmation of infection. The assessment also points out the heavy cost on health systems during concurrent epidemics, including the disruption of dengue surveillance and vector control programs, a shortage of health resources and the increased pressure on hospitals and health workers. Effective management of these co-epidemics involves integrated surveillance systems, stronger laboratory infrastructure, continued vector control, public awareness efforts and multidisciplinary clinical management. Preparedness, early identification and coordinated public health measures are important to minimise morbidity and mortality from concurrent outbreaks of dengue and COVID-19.
Keywords: Co-epidemics, COVID-19, Dengue, Epidemiology, SARS-CoV-2, WHO.