Long-Term Outcomes After Dengue vs SARS-CoV-2 Infections in Children
Overview
This retrospective cohort study compared long-term postacute sequelae in Singaporean children following dengue versus SARS-CoV-2 infections. Dengue-infected children showed higher risk of gastrointestinal sequelae, particularly appendicitis, but overall lower risk of respiratory and other postacute complications compared to COVID-19 cases.
Background
Long-term postacute sequelae after SARS-CoV-2 infection in children are well documented, involving multiple organ systems. Dengue, a tropical viral infection with seasonal epidemics, has also been associated with chronic symptoms, but population-based pediatric data are limited. Given the resurgence of dengue globally, understanding its long-term impact compared to COVID-19 is critical. This study addresses this gap by analyzing national registry data from Singaporean children aged 1 to 17 years.
Data Highlights
Outcome
Adjusted Hazard Ratio (aHR)
95% Confidence Interval
Excess Burden
Any postacute gastrointestinal sequelae (dengue vs COVID-19)
2.98
1.18–7.18
Not reported
Appendicitis (dengue vs COVID-19)
3.50
1.36–8.99
Not reported
Any sequelae (dengue vs unvaccinated COVID-19)
0.42
0.29–0.61
−6.50 (95% CI, −9.80 to –3.20)
Respiratory sequelae (dengue vs COVID-19)
0.17
0.09–0.31
Not reported
Key Findings
Children with dengue infection had nearly 3-fold increased risk of postacute gastrointestinal complications compared to those with SARS-CoV-2 infection.
Risk of appendicitis was significantly higher in dengue-infected children (aHR 3.50) compared to COVID-19 cases.
Overall risk of any postacute sequelae was lower in dengue cases compared to unvaccinated COVID-19 children (aHR 0.42) with a negative excess burden.
Dengue-infected children had markedly lower risk of respiratory sequelae than those with COVID-19 (aHR 0.17).
The study included 6,452 dengue cases and 260,749 COVID-19 cases, providing robust population-based data.
Clinical Implications
Clinicians should be aware that while dengue infection in children generally results in fewer long-term complications than COVID-19, there is a notable increased risk of gastrointestinal sequelae such as appendicitis. Monitoring for postinfectious gastrointestinal symptoms following dengue is warranted. Public health strategies should incorporate the potential for chronic postinfectious sequelae in both dengue and COVID-19 pediatric populations.
Conclusion
This large population-based study demonstrates that pediatric dengue infection carries a lower overall risk of long-term complications than SARS-CoV-2 infection but is associated with increased gastrointestinal risks, particularly appendicitis. These findings highlight the need for tailored postinfection surveillance and management strategies for children recovering from these viral infections.
References
Comparative Analysis of Long-Term Outcomes After Dengue and SARS-CoV-2 Infections in Children: A Retrospective Cohort Investigation
