Distinguishing non severe cases of dengue from COVID-19 in the context of co-epidemics: a cohort study in a SARS-CoV-2 testing center on Reunion island

A. Joubert, F. Andry, A. Bertolotti, F. Accot, Y. Koumar, F. Legrand, P. Poubeau, R. Manaquin, P. Gérardin, C. Levin

medRxiv, 2020

Background. As coronavirus (COVID-19) is spreading globally, several countries are handling dengue epidemics. As both infections are deemed to share similarities at presentation, it would be useful to distinguish COVID-19 from dengue in the context of co-epidemics. In this aim, we performed a cohort study to identify predictors of both infections. Methods. All the subjects suspected of COVID-19 between March 23 and May 10, 2020, were screened for COVID-19 within the testing center of the University hospital of Saint-Pierre, Reunion island. The screening consisted in a questionnaire surveyed in face-to-face, a nasopharyngeal swab specimen for the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) reverse transcription polymerase chain-reaction and a rapid diagnostic orientation test for dengue. Factors independently associated with COVID-19 or with dengue were sought using multinomial logistic regression models, taking other febrile illnesses (OFIs) as controls. Results. Over a two-month study period, we identified among 80 COVID-19, 60 dengue and 872 OFIs cases, delayed presentation (>3 days) since symptom onset (Odds ratio 1.89, 95% confidence interval 1.4-3.40), contact with a COVID-19 positive case (OR 3.81, 95%CI 2.12-6.82) and anosmia (OR 8.27, 95%CI 4.39-15.54) as independent predictors of COVID-19, body ache (OR 6.83, 95%CI 2.84-16.41), headache (OR 5.38, 95%CI 1.81-15.94) and retro-orbital pain (OR 7.45, 95%CI 3.17-17.50) as independent predictors of dengue, while smoking was less likely observed with COVID-19 (OR 0.27, 95%CI 0.10-0.74). Conclusions. Although prone to potential biases, these data suggest that dengue may be more symptomatic than COVID-19 in a co-epidemic setting with higher dengue attack rates.

Cited by 1 publication.

Field of study: Medicine

10.1101/2020.10.20.20214718