QCOSTARICA – Covidengue: is it Dengue or is it COVID-19? Specialists pointed out that beyond COVID-19 today, there are other diseases that can represent a serious health problem, including dengue, which infecting a patient with coronavirus can result in serious complications.
Yes, you can have both diseases at the same time.
You can have COVID-19 and dengue, or COVID-19 and malaria, that’s why not only can we think of COVID-19 when we take care of our health, we can be unlucky enough to have both at the same time, it is something very rare, but it is possible,” explains Catalina Ramírez Hernández, coordinator of Emerging and Reemerging diseases of the Costa Rican Social Security Fund (CCSS).
Ramírez indicated that it has not yet been seen in the country. However, this type of situation is already beginning to reveal itself in the international scientific literature.
Mexico’s La Revista Peninsular reported today, October 3, of the first case of Covidengue in the Yucatán peninsula.
Geovani Natalio Ramos Reséndiz, a doctor specializing in Medical-Surgical Emergencies, told La Revista that in the state of Yucatán there have been cases in which both viruses coexist in one person.
“We learned of a case in (the state of ) Campeche that had Dengue and Covid-19 and ended up dying. In Dengue, it is very important to inform and educate people about the symptoms and explain that when your temperature drops, or you have bleeding from the gums, nose or abdomen, the disease can be complicated. You have to anticipate what can happen to people,” he added.
El Financiero Mexico reported on July 30 that the Jalisco Health Secretariat confirmed the first death of a patient who was infected with COVID-19 and Dengue at the same time. The deceased was the second patient detected with COVID-19 and dengue.
Four other people, males between 7 and 52 years of age, residents of the municipalities of Jocotepec, Poncitlán, El Salto, Tlaquepaque and Guadalajara, were also reported having both diseases at the same time. The first case occurring in June in a 7-year-old boy; the other three patients 29, 38 52 years old, all recovered.
Countries such as Argentina, Brazil, Singapore, Thailand, India, Bangladesh and the islands of Mayotte and Reunion, in France, have seen isolated cases Covidengue.
“For all countries that are making it difficult to attack COVID-19, an outbreak or epidemic of dengue will lead to new challenges to combat. A combination of both diseases in a person should be assumed as risk by health professionals in any country,” highlights an article published in July in the Journal of Medical Virology.
This situation of coinfection could occur in a country where dengue is an endemic disease. Costa Rica is one of them and in fact, this year has had much higher figures compared to previous periods.
Data from the CCSS indicate that this is the year with the most cases in the last five years. At week 32, which closed on August 22, there is an increase in patients of 114% compared to the same date in 2019 and 518% compared to the same period in 2018.
While COVID-19 cases are the focus of daily reports, dengue has been doing its share of making people sick, with almost 10,000 cases by the middle of last month.
“In mid-September we are close to 9,300 cases, last year it closed with about 10,000. We are thinking a lot about COVID-19, but all the rest of the diseases are still there, dengue, zika, malaria, influenza continue, and we must take care of all of them,” said Catalina Ramírez Hernández.
The specialist pointed out that, to date, there have been about 400 hospitalized dengue patients.
Is it Dengue or is it COVID-19?
According to the Centers for Disease Control and Prevention (CDC), most people with dengue and COVID-19 have mild illness and can recover at home; symptoms usually last a few days, and people tend to feel better after a week.
However, both dengue and COVID-19 can cause severe illness that can result in death.
The clinical management for people who develop severe illness with either of these two diseases is quite different, often requiring hospital-based care. Anyone of any age can develop severe illness with dengue or COVID-19. Both infections are more likely to cause complications in adults with underlying chronic conditions, such as diabetes and heart disease.
Complications for both dengue and COVID-19 can develop before test results come back.
Dengue
Dengue, an illness caused by any of 4 dengue viruses, is mainly transmitted to people through the bites of infected Aedes species mosquitoes (primarily Ae. aegypti or Ae. albopictus species).
The incubation period for dengue ranges between 3-10 days, typically 5-7 days.
The clinical manifestations of both dengue and COVID-19 can range from mild to critical.
Signs and Symptoms
Febrile phase
- Fever
- Headache with eye pain
- Myalgia
- Nausea
- Vomiting
- Rash
- Leukopenia
Warning signs for severe illness: abdominal pain or tenderness, persistent vomiting, clinical fluid accumulation, mucosal bleeding, lethargy, restlessness, and liver enlargement.
Critical Phase
- Warning signs may appear, and rapid clinical deterioration may occur within 48 hours after defervescence (3–7 days after fever onset).
Severe dengue
Severe Dengue is defined by dengue with any of the following symptoms and signs:
- Plasma leakage leading to shock
- Fluid accumulation with respiratory distress
- Severe bleeding with thrombocytopenia
- Severe organ impairment such as liver disease with elevated transaminases, or meningoencephalitis with impaired consciousness
- Heart impairment
Risk factors for severe dengue include:
- Age (infant)
- Second dengue infection
- In most dengue-endemic countries, children and young adults are at highest risk for a second infection
- Patients with chronic medical conditions, including diabetes, asthma, or heart disease
COVID-19
COVID-19, a respiratory illness caused by the virus SARS-CoV-2, is mainly transmitted from person to person through respiratory droplets that are spread when an infected person coughs, sneezes, or talks.
The incubation period for COVID-19 is thought to extend to 14 days, with a median of 4-5 days from exposure to symptoms onset.
The clinical manifestations of both dengue and COVID-19 can range from mild to critical.
Signs and Symptoms
Mild to moderate disease
- Fever or chills
- Cough
- Shortness of breath or difficulty breathing
- Fatigue
- Muscle or body aches
- Headache
- New loss of taste or smell
- Sore throat
- Congestion or runny nose
- Nausea or vomiting
- Diarrhea
NOTE: These signs and symptoms of COVID-19 are the ones most persons with the illness have experienced. However, this list is not inclusive.
Severe Illness
Among patients who developed severe disease, the medium time to dyspnea ranged from 5 to 8 days, the median time to acute respiratory distress syndrome (ARDS) ranged from 8 to 12 days, and the median time to ICU admission ranged from 10 to 12 days.
Signs and symptoms for severe illness can include:
- dyspnea
- hypoxia
- respiratory failure
- shock
- multiorgan system dysfunction
Risk Factors for Severe Illness
Risks factors for severe illness with COVID-19 include:
- Age over 65
- Underlying conditions like cardiovascular disease, diabetes, chronic respiratory disease, hypertension, prior stroke, liver disease, obesity, chronic lung disease, chronic kidney disease undergoing dialysis, or immunocompromised (e.g., poorly controlled HIV, undergoing cancer treatment, using corticosteroids, smoking)
- People who live in a nursing home or long-term care facility
