Next Article in Journal
Eliminating Cholera Incidence and Mortality: Unfulfilled Tasks
Next Article in Special Issue
Characteristics of COVID-19 Breakthrough Infections among Vaccinated Individuals and Associated Risk Factors: A Systematic Review
Previous Article in Journal
Oral Rehydration Salts, Cholera, and the Unfinished Urban Health Agenda
Previous Article in Special Issue
Transmission of SARS-CoV-2 in the Population Living in High- and Low-Density Gradient Areas in Dhaka, Bangladesh
Article

Dengue and COVID-19: Managing Undifferentiated Febrile Illness during a “Twindemic”

1
Department of Infectious Diseases, Singapore General Hospital, Singapore 169608, Singapore
2
Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore 169608, Singapore
*
Author to whom correspondence should be addressed.
Academic Editor: Richard J. Maude
Trop. Med. Infect. Dis. 2022, 7(5), 68; https://doi.org/10.3390/tropicalmed7050068
Received: 2 April 2022 / Revised: 29 April 2022 / Accepted: 30 April 2022 / Published: 7 May 2022
(This article belongs to the Special Issue COVID-19: Current Status and Future Prospects)
Background: During the COVID-19 pandemic, distinguishing dengue from COVID-19 in endemic areas can be difficult, as both may present as undifferentiated febrile illness. COVID-19 cases may also present with false-positive dengue serology. Hospitalisation protocols for managing undifferentiated febrile illness are essential in mitigating the risk from both COVID-19 and dengue. Methods: At a tertiary hospital contending with COVID-19 during a dengue epidemic, a triage strategy of routine COVID-19 testing for febrile patients with viral prodromes was used. All febrile patients with viral prodromes and no epidemiologic risk for COVID-19 were first admitted to a designated ward for COVID-19 testing, from January 2020 to December 2021. Results: A total of 6103 cases of COVID-19 and 1251 cases of dengue were managed at our institution, comprising a total of 3.9% (6103/155,452) and 0.8% (1251/155,452) of admissions, respectively. A surge in dengue hospitalisations in mid-2020 corresponded closely with the imposition of a community-wide lockdown. A total of 23 cases of PCR-proven COVID-19 infection with positive dengue serology were identified, of whom only two were true co-infections; both had been appropriately isolated upon admission. Average length-of-stay for dengue cases initially admitted to isolation during the pandemic was 8.35 days (S.D. = 6.53), compared with 6.91 days (S.D. = 8.61) for cases admitted outside isolation (1.44 days, 95%CI = 0.58–2.30, p = 0.001). Pre-pandemic, only 1.6% (9/580) of dengue cases were admitted initially to isolation-areas; in contrast, during the pandemic period, 66.6% (833/1251) of dengue cases were initially admitted to isolation-areas while awaiting the results of SARS-CoV-2 testing. Conclusions: During successive COVID-19 pandemic waves in a dengue-endemic country, coinfection with dengue and COVID-19 was uncommon. Routine COVID-19 testing for febrile patients with viral prodromes mitigated the potential infection-prevention risk from COVID-19 cases, albeit with an increased length-of-stay for dengue hospitalizations admitted initially to isolation. View Full-Text
Keywords: dengue; COVID-19; SARS-CoV-2; undifferentiated febrile illness; antigen testing dengue; COVID-19; SARS-CoV-2; undifferentiated febrile illness; antigen testing
Show Figures

Figure 1

MDPI and ACS Style

Wee, L.E.; Conceicao, E.P.; Sim, J.X.-Y.; Aung, M.K.; Oo, A.M.; Yong, Y.; Arora, S.; Venkatachalam, I. Dengue and COVID-19: Managing Undifferentiated Febrile Illness during a “Twindemic”. Trop. Med. Infect. Dis. 2022, 7, 68. https://doi.org/10.3390/tropicalmed7050068

AMA Style

Wee LE, Conceicao EP, Sim JX-Y, Aung MK, Oo AM, Yong Y, Arora S, Venkatachalam I. Dengue and COVID-19: Managing Undifferentiated Febrile Illness during a “Twindemic”. Tropical Medicine and Infectious Disease. 2022; 7(5):68. https://doi.org/10.3390/tropicalmed7050068

Chicago/Turabian Style

Wee, Liang E., Edwin P. Conceicao, Jean X.-Y. Sim, May K. Aung, Aung M. Oo, Yang Yong, Shalvi Arora, and Indumathi Venkatachalam. 2022. "Dengue and COVID-19: Managing Undifferentiated Febrile Illness during a “Twindemic”" Tropical Medicine and Infectious Disease 7, no. 5: 68. https://doi.org/10.3390/tropicalmed7050068

Find Other Styles
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Back to TopTop