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Potential Misdiagnosis between COVID-19 and Dengue Infection Using Rapid Serological Test
Siti Qamariyah Khairunisa1, Ilham Harlan Amarullah1, Siti Churrotin1
1Institute of Tropical Disease, Universitas Airlangga, Surabaya 60115, Indonesia.
Insights
Distinguishing between COVID-19 and dengue is challenging due to similar symptoms. This study highlights potential antibody cross-reactivity and the need for accurate diagnostic tests in endemic regions.
Area of Science:
- Infectious Diseases
- Virology
- Epidemiology
Background:
- The COVID-19 pandemic presents diagnostic challenges, especially in dengue-endemic regions like Indonesia, due to overlapping early symptoms with dengue.
- Differentiating between SARS-CoV-2 and dengue virus infections is crucial for effective patient management and public health response.
Purpose of the Study:
- To analyze IgG and IgM profiles in COVID-19 patients using serological rapid tests for SARS-CoV-2 and dengue.
- To investigate potential antibody cross-reactivity between COVID-19 and dengue infections.
- To assess the prevalence of prior dengue exposure in a healthy Indonesian population.
Main Methods:
- Serological analysis of 120 samples from COVID-19 patients using rapid tests for SARS-CoV-2 and dengue (IgG/IgM).
- Dengue rapid testing (IgG/IgM and NS1) on 38 pre-COVID-19 sera from healthy individuals.
- RT-PCR was used to confirm SARS-CoV-2 status.
Main Results:
- Among 120 COVID-19 patient samples, 4 showed positive dengue IgG, but negative IgM, NS1, and RT-PCR results.
- In the healthy control group, 2 out of 38 individuals tested positive for dengue IgG, with one also positive for NS1.
- Findings suggest prior dengue exposure in the population and potential antibody cross-reactivity.
Conclusions:
- A significant portion of the population in dengue-endemic areas may have existing immunity to dengue virus.
- Antibody cross-reactivity between SARS-CoV-2 and dengue infections is a possibility that requires further investigation.
- There is a critical need for highly sensitive and specific rapid diagnostic methods to accurately differentiate between COVID-19 and dengue.
Abstract:
The coronavirus disease 2019 (COVID-19) pandemic that has a significant rapid transmission is an international public health concern. Several dengue-endemic countries reported similar clinical and laboratory features between COVID-19 and dengue in the early incubation period, and thus discerning the infection is difficult. As a dengue-endemic country, Indonesia also poses the same challenge during the COVID-19 outbreak. This current study analyzed the IgG and IgM profiles from COVID-19 patients by using a serological SARS-CoV-2 and dengue rapid test. In addition, 38 sera from healthy individuals (pre-COVID-19 date) were analyzed using a dengue rapid test. Among 120 samples, 4 samples indicated dengue IgG positive. However, IgM, NS1, and RT-PCR analyses showed negative results. Interestingly, regarding seropositivity of NS1 and DENV IgG from healthy individuals (pre COVID-19 infection), two samples were positive DENV IgG, while one of them was positive NS1. This suggested that in the dengue-endemic area, many people have already experienced dengue and have immunity against dengue virus. There is also the possibility of antibody cross-reactivity between COVID-19 and dengue infection. This also emphasizes the high demand for a rapid method with high sensitivity and specificity that can distinguish between SARS-CoV-2 and dengue.
