COVID-19 with dengue shock syndrome in a child: coinfection or cross-reactivity?

BMJ Case Rep. 2020 Dec 21;13(12):e239315. doi: 10.1136/bcr-2020-239315.

Abstract

COVID-19, caused by SARS-CoV-2, has spread globally. Coinfection with other endemic viruses is likely to complicate the clinical presentation and outcome. Information on clinical manifestations and management strategies on COVID-19 coinfection with endemic diseases in children is yet to evolve. The risk of dengue infection exists in 129 countries and it is endemic in more than 100 countries. The SARS-CoV-2 pandemic might overlap with the dengue epidemics in tropical countries. We report the first paediatric case to the best of our knowledge of COVID-19 encephalitis with dengue shock syndrome. This clinical syndrome could be attributed to serological cross-reactivity, incidental coinfection or perhaps a warning for dengue-endemic regions to face the unique challenge of differentiating and managing two disease entities together. Enhanced understanding of potential COVID-19 and dengue coinfection warrants immediate attention of researchers and international health policy makers.

Keywords: coma and raised intracranial pressure; global health; influenza; paediatric intensive care; tropical medicine (infectious disease).

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Antibodies, Viral / analysis
  • COVID-19 / epidemiology*
  • Coinfection / epidemiology*
  • Dengue Virus / immunology*
  • Female
  • Humans
  • Pandemics*
  • SARS-CoV-2 / immunology*
  • Severe Dengue / diagnosis
  • Severe Dengue / epidemiology*
  • Tomography, X-Ray Computed

Substances

  • Antibodies, Viral