Phung Nguyen The Nguyen, Tran Minh Nhut, Tran Thanh Thuc, Vo Duy Minh
Pediatrics, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, VNM.
Infectious Diseases Intensive Care Unit, Children Hospital No. 1, Ho Chi Minh City, VNM.
Cureus. 2024 Aug 9;16(8):e66535. doi: 10.7759/cureus.66535. eCollection 2024 Aug.
Introduction Dengue is an infectious disease that is a burden in Asia-Pacific and Latin America. The COVID-19 pandemic in dengue-endemic areas has caused a "double burden" because of the possibility of coinfection, especially in children who are vulnerable to both COVID-19 and dengue. This study aimed to describe the characteristics and identify risk factors for the severity of the coinfection in Vietnamese children. Methods This was a retrospective cohort study, undertaken at Children's Hospital 1 (Ho Chi Minh City, Vietnam) during the fourth wave of the COVID-19 pandemic. All children under 16 years old who were admitted to the hospital from April 27, 2021 to June 30, 2022, and diagnosed with SARS-CoV-2 and dengue coinfection were included. Results From April 2021 to June 2022, a total of 31 patients with the coinfection were included, with 19 of them being male (61.3%). The median age was 10.8 years old (IQR, 5.1-14.1). Fourteen children (45.2%) had preexisting comorbidities, with the most common comorbidity being overweight/obesity (ten children). Nearly two-thirds of the children were diagnosed with dengue without/with warning signs (61.3%) and were classified as having mild COVID-19 (83.9%). The most frequently observed clinical characteristics were fever (n=29, 93.6%), followed by abdominal pain, vomiting, and petechiae. All patients had high serum ferritin, and 83.9% presented with thrombocytopenia. None of the cases died. Overweight/obesity, abdominal pain, and petechiae were factors independently associated with severe disease. Conclusion Most of the children had mild COVID-19 and disease progression similar to patients with dengue alone. However, some children may have severe COVID-19 and dengue coinfection. Obesity, abdominal pain, and petechiae were identified as independent risk factors for disease severity in pediatric cases. Further studies with multicenters and a larger sample size are needed to assess the coinfection more thoroughly.
引言
登革热是一种传染病，在亚太地区和拉丁美洲构成负担。登革热流行地区的新冠疫情造成了“双重负担”，因为存在合并感染的可能性，尤其是在易感染新冠和登革热的儿童中。本研究旨在描述越南儿童合并感染的特征并确定严重程度的危险因素。
方法
这是一项回顾性队列研究，在新冠疫情第四波期间于越南胡志明市第一儿童医院开展。纳入2021年4月27日至2022年6月30日期间入院且诊断为新冠病毒和登革热合并感染的所有16岁以下儿童。
结果
从2021年4月至2022年6月，共纳入31例合并感染患者，其中19例为男性（61.3%）。中位年龄为10.8岁（四分位间距，5.1 - 14.1）。14名儿童（45.2%）有既往合并症，最常见的合并症是超重/肥胖（10名儿童）。近三分之二的儿童诊断为无/有警示体征的登革热（61.3%），并被归类为轻症新冠（83.9%）。最常观察到的临床特征是发热（n = 29，93.6%），其次是腹痛、呕吐和瘀点。所有患者血清铁蛋白均升高，83.9%出现血小板减少。无一例死亡。超重/肥胖、腹痛和瘀点是与重症独立相关的因素。
结论
大多数儿童为轻症新冠，疾病进展与单纯登革热患者相似。然而，一些儿童可能患有重症新冠和登革热合并感染。肥胖、腹痛和瘀点被确定为儿科病例疾病严重程度的独立危险因素。需要进一步开展多中心、更大样本量的研究以更全面地评估合并感染情况。
