Sri Masyeni, Marsha S. Santoso, Putu Dyah Widyaningsih, DG Wedha Asmara, Firzan Nainu, Harapan Harapan, R Tedjo Sasmono
Similar symptoms and laboratory findings between dengue and coronavirus disease 2019 (COVID-19) pose a diagnostic challenge in some dengue-endemic countries in Asia. In this study, we reported three cases of suspected COVID-19-dengue coinfection in hospitals of Bali, Indonesia. Serological data demonstrated that patients with positive results for dengue virus (DENV) NS1 antigen and anti-dengue IgM were also reactive to COVID-19 rapid antibody tests, suggesting dengue−COVID-19 coinfection. However, two patients were later confirmed negative for SARS−COV-2 by qRT-PCR, implying a plausible cross-reactivity of anti-dengue and anti−COVID-19 antibodies in the serological test. Coinfection of dengue and COVID-19 was evident in one patient, following confirmation of SARS−COV-2 by qRT-PCR and DENV infection using the NS1 antigen serology test. This case was the first case of dengue and COVID-19 coinfection in Indonesia and revealed possible cross-reactivity between SARS−COV-2 and DENV antibodies based on rapid serological tests. Our study indicates a public health concern regarding COVID-19 and dengue detection in Indonesia as well as in other dengue-endemic countries, and it is important for these nations to manage both pathogens concurrently. © 2020 The Author(s)
Department of Internal Medicine, Faculty of Medicine and Health Sciences, Universitas Warmadewa, Denpasar, 80235, Bali, Indonesia; Department of Internal Medicine, Sanjiwani Hospital, Denpasar, 80235, Bali, Indonesia; Eijkman Institute for Molecular Biology, Jakarta, 10430, Indonesia; Faculty of Pharmacy, Hasanuddin University, Makassar, 90245, Indonesia; Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, 23111, Indonesia; Tropical Disease Centre, School of Medicine, Universitas Syiah Kuala, Banda Aceh, 23111, Indonesia; Department of Microbiology, School of Medicine, Universitas Syiah Kuala, Banda Aceh, 23111, Indonesia; Infectious Disease Laboratory, Universitas Syiah Kuala, Banda Aceh, 23111, Indonesia
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