THE IMPACT OF COINFECTION OF DENGUE AND COVID-19 ON CLINICAL OUTCOMES

Abstract

 The concurrent circulation of dengue virus and SARS-CoV-2 in tropical and subtropical regions has raised concerns about the clinical implications of coinfection. Overlapping symptomatology and immunopathological mechanisms pose diagnostic and therapeutic challenges, yet evidence on the clinical outcomes of coinfection remains limited. To evaluate the impact of dengue and COVID-19 coinfection on clinical presentation, laboratory findings, treatment modalities, and patient outcomes compared to monoinfection. Three groups of 900 patients—300 with dengue alone, 300 with COVID-19 alone, and 300 with dengue-COVID-19 coinfection—were included in a retrospective, multi-center observational analysis. Analysis was done on imaging results, laboratory results, clinical data, treatment plans, and results. Mortality predictors were found using multivariate logistic regression. Compared to dengue (4%) and COVID-19 (11%) monoinfection groups, coinfected patients showed noticeably greater rates of ICU hospitalisation (28%), mechanical ventilation (19%), and mortality (12%). Coinfection was linked to greater D-dimer levels (2.3 mg/L), higher CRP (56 mg/L), and lower platelet counts (mean 98 ×10³/μL), indicating a compounded inflammatory and coagulopathic profile. Ground-glass opacities and lung infiltrates were common radiological findings, while rash and gastrointestinal symptoms complicated the diagnosis. Coinfection status (OR 2.17, 95% CI: 1.31–3.61), advanced age, high CRP, and low platelet count were all found to be independent predictors of death using logistic regression. Cross-reactivity in serological assays (42%) and delayed RT-PCR results hindered prompt diagnosis, making diagnostic difficulties prevalent. To increase accuracy, the use of integrated clinical scoring systems and multiplex assays was recommended. The co-occurrence of dengue with COVID-19 leads to worse clinical outcomes, longer hospital stays, and higher fatality rates. Improving the prognosis for coinfected patients requires early detection, quick diagnostics, and vigorous supportive care. In order to properly manage this newly developing dual illness burden, the study emphasises the necessity of region-specific protocols and improved surveillance systems.