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Long-term Sequelae Following Dengue Infection vs SARS-CoV-2 Infection in a Pediatric Population: A Retrospective

Liang En Wee1,2,3,4, Jue Tao Lim1,4, Janice Yu Jin Tan5

  • 1National Centre for Infectious Diseases, Singapore.

Open Forum Infectious Diseases
|March 31, 2025
PubMed

Insights

Children with dengue infection had a lower overall risk of postacute complications compared to those with COVID-19. However, dengue infection increased the risk of appendicitis in children, highlighting the need for tailored public health strategies.

Area of Science:

  • Pediatric Infectious Diseases
  • Epidemiology
  • Public Health

Background:

  • Long-term postacute sequelae following SARS-CoV-2 infection in children are well-documented.
  • Population-based studies on chronic symptoms after pediatric dengue infection are limited.
  • This study compares multisystemic complications after dengue versus SARS-CoV-2 in Asian children.

Purpose of the Study:

  • To evaluate the risk of multisystemic complications following dengue infection in children.
  • To compare these risks with those following SARS-CoV-2 infection in a pediatric Asian population.
  • To inform public health strategies for managing postinfectious sequelae in children.

Main Methods:

  • Retrospective population-based cohort study using national registries.
  • Inclusion of Singaporean children aged 1-17 with laboratory-confirmed dengue or SARS-CoV-2.
  • Cox regression analysis to assess risks of cardiovascular, neurologic, gastrointestinal, autoimmune, and respiratory complications 31-300 days post-infection.

Main Results:

  • Included 6,452 dengue cases and 260,749 COVID-19 cases.
  • Dengue infection was associated with increased risk of postacute gastrointestinal sequelae, including appendicitis (aHR, 3.50).
  • Dengue infection showed lower overall risk (aHR, 0.42) and respiratory sequelae risk (aHR, 0.17) compared to unvaccinated COVID-19.

Conclusions:

  • Children experienced a lower overall risk of postacute complications after dengue infection compared to COVID-19.
  • Appendicitis risk was higher 31-300 days after dengue infection versus SARS-CoV-2.
  • Public health strategies must consider chronic postinfectious sequelae for both dengue and COVID-19 in children.
Abstract

Keywords:
COVID-19SARS-CoV-2denguelong termpostacute sequelae

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