登革热和 COVID-19 的合并感染和交叉反应：病例系列分析。

Coinfection and cross-reaction of dengue and COVID-19: a case series analysis.

机构信息

Universidade Estadual de Maringá, Departamento de Medicina, Programa de Mestrado Profissional em Gestão, Tecnologia e Inovação em Urgência e Emergência, Maringá, PR, Brasil.

Universidade Estadual de Maringá, Departamento de Medicina, Maringá, PR, Brasil.

出版信息

Rev Soc Bras Med Trop. 2022 Oct 21;55:e02432022. doi: 10.1590/0037-8682-0243-2022. eCollection 2022.

DOI:10.1590/0037-8682-0243-2022

PMID:36287508

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9592094/

Abstract

BACKGROUND

The risk of possible cross-reactions between serological tests, together with the clinical similarities between dengue fever and COVID-19, can delay diagnosis and increase the risk of both COVID-19 transmission and worsening. The present study aimed to determine the possibility of cross-reactions among rapid serological tests based on clinical symptoms.

METHODS

Patients with COVID-19, confirmed by RT-PCR and clinical criteria for diagnosing dengue, were recruited consecutively between September 2020 and August 2021 and underwent rapid immunochromatographic diagnostic (RID) tests for AgNS1, IgM, and IgG. Patients who tested positive for acute-phase dengue IgM and AgNS1 underwent a follow-up test after 12-30 days for diagnostic confirmation.

RESULTS

A total of 43 patients were included, 38 of whom required hospital admission, and 8 received intensive care. Seven patients tested positive on the RID tests, comprising 2 NS1 positive (coinfection), one reactive for IgM and IgG (coinfection), three reactive for IgM not confirmed (false-positive), and one reactive for IgG due to previous infection. Two of the 3 patients with coinfection died. Fever, myalgia, headache, and cough were the most common clinical symptoms, while lymphopenia was the most prevalent laboratory finding.

CONCLUSIONS

Cross-reactivity was found in only three patients and coinfection in another three patients, two of whom died of severe COVID-19 manifestations.

摘要

背景

血清学检测之间可能存在交叉反应的风险，再加上登革热和 COVID-19 之间的临床相似性，可能会延迟诊断并增加 COVID-19 传播和恶化的风险。本研究旨在根据临床症状确定基于快速血清学检测之间发生交叉反应的可能性。

方法

2020 年 9 月至 2021 年 8 月连续招募了经 RT-PCR 和诊断登革热的临床标准确诊的 COVID-19 患者，并进行了快速免疫层析诊断（RID）检测 NS1Ag、IgM 和 IgG。对急性期登革热 IgM 和 AgNS1 检测呈阳性的患者在 12-30 天后进行随访检测以确认诊断。

结果

共纳入 43 例患者，其中 38 例需要住院治疗，8 例接受重症监护。RID 检测有 7 例阳性，包括 2 例 NS1 阳性（合并感染），1 例 IgM 和 IgG 反应（合并感染），3 例 IgM 反应未确认（假阳性），1 例 IgG 反应因既往感染。2 例合并感染的患者死亡。发热、肌痛、头痛和咳嗽是最常见的临床症状，而淋巴细胞减少是最常见的实验室发现。