登革热COVID-19重叠：抗原模仿或同时存在两种病毒性疾病

IF 0.8 Q3 MEDICINE, GENERAL & INTERNAL

Bangladesh Journal of Medical Science Pub Date : 2024-01-01 DOI:10.3329/bjms.v23i1.70712

Patil Shital, S. Toshniwal, U. Dhumal

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引用次数: 0

摘要

背景：登革热-COVID-19重叠是两种疾病的混合物，在肺部和肺外受累方面有一些相似之处。由于这两种疾病后来都成为大流行病，发病率很高，而且实验室和临床参数也有重叠，因此我们在印度的三级医院开展了一项研究，观察登革热-COVID-19 的重叠情况。研究方法前瞻性观察研究纳入了 600 例登革热 NS1 或登革热 IgM 阳性的 COVID-19 病例，这些病例在入院时经 HRCT 胸部检查发现肺部受累并进行了分类。所有病例均在出院 12 周后接受登革热 IgG 抗体滴度和登革热 IgM/IgG 抗体滴度分析。结果16.33%（98/600）的病例存在登革热-COVID-19重叠。CT严重程度与登革热-COVID-19重叠病例有明显相关性。[血液学评估、白细胞计数和血小板计数分别与登革热-COVID-19重叠病例有显著相关性[p<0.0076]和[p<0.00001]。缺氧等临床参数与登革热-COVID-19重叠有显著相关性。[炎症指标 IL-6、CRP 和 LDH 分别与登革热-COVID-19 重合有显著相关性 [p<0.00001]。在对 98 例 "登革热-COVID-19 "病例的研究中，合并感染后肺纤维化[p<0.004]与登革热 IgM/IgG 和合并感染抗体滴度的血清学评估有显著关联[p<0.00001] 结论：登革热-COVID-19重叠是一种临床综合征，两种疾病的临床和实验室检查均有重叠。在登革热流行的热带地区，对所有合并登革热的病例都必须高度怀疑；所有白细胞和血小板减少伴发热的病例都应进行登革热血清学筛查。据了解，登革热血清学假阳性或登革热抗原交叉反应可发生在潜在的 COVID-19 疾病中，并对临床结果产生影响，因为这将导致延误开始适当的登革热治疗，许多病例因进展性登革热肺炎而需要重症监护室治疗。孟加拉国医学科学杂志》第 23 卷第 01 期 January'24 Page : 189-199

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Dengue COVID-19 overlap: antigenic mimicry or concurrent two viral diseases

Background: Dengue-COVID-19 overlap is mixture of both diseases sharing few similarities in pulmonary and extrapulmonary involvement. Due to high prevalence of both diseases later being pandemic disease, and overlapping laboratory and clinical parameters we have conducted a study to observe dengue-COVID-19 overlap in Indian settings in tertiary care hospitals. Methods: Prospective, observational study, included 600 COVID-19 cases with dengue NS1 or Dengue IgM positive, with lung involvement documented and categorized on HRCT thorax at entry point. All cases were subjected to dengue IgG antibody titers and dengue IgM/IgG antibody titer analysis after 12 weeks of discharge form hospital. Results: Dengue- COVID-19 overlap was documented in 16.33% (98/600) cases. CT severity has documented significant correlation with Dengue-COVID-19 overlap cases. [p<0.00001] Hematological evaluation, white blood cell count & platelet count were having significant association with Dengue-COVID-19 overlap [p<0.0076] & [p<0.00001] respectively. Clinical parameters as hypoxia have significant association with dengue- COVID-19 overlap. [p<0.00001] Inflammatory markers as IL-6, CRP and LDH has significant association in dengue-COVID-19overlap [p<0.00001] respectively. In study of 98 cases of ‘Dengue-COVID-19’, post covid lung fibrosis [p<0.004] and serological assessment in dengue IgM/IgG and covid antibody titers has significant association [p<0.00001] Conclusion: Dengue-COVID-19 overlap is clinical syndrome with overlapping clinical and laboratory workup of both the illnesses. High index of suspicion is must in all covid cases in tropical settings where dengue is endemic; and all cases with leucopenia and thrombocytopenia with fever should be screened for dengue serology. False positive dengue serology or dengue antigen crossreactivity is known to occur in underlying COVID-19 illness, and have impact on clinical outcome as it will result in delay in covid appropriate treatment initiation and many cases require intensive care unit treatment due to progressed covid pneumonia. Bangladesh Journal of Medical Science Vol. 23 No. 01 January’24 Page : 189-199

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