Clinical Scorecard: Epidemiological Insights into Dengue and COVID-19 Co-infection in Dhaka, Bangladesh (2021–2023): Findings from a Cross-sectional Analysis

At a Glance

Key Highlights

• 31% of participants had co-infection of dengue and COVID-19 with higher prevalence in Jatrabari (14%) and Motijhil (11%)
• Co-infected individuals had significantly higher rates of severe and very severe symptoms, especially those over 50 years
• Co-infection was associated with increased long-term illness and higher frequency of heart damage (31.6%), brain fog (22%), and kidney damage (49.3%)

Guideline-Based Recommendations

Diagnosis

• Use WHO-recommended tests for dengue (NS1 antigen, IgM/IgG ELISA, RT-PCR) and COVID-19 (multiplex RT-PCR) for accurate detection
• Include testing for both infections in symptomatic individuals in endemic areas

Management

• Monitor co-infected patients closely for severe symptoms and organ damage
• Provide supportive care addressing fever, weakness, respiratory symptoms, and complications such as heart and kidney damage

Monitoring & Follow-up

• Track symptom severity, especially in patients aged >50 years
• Follow-up for long-term illness and neurological symptoms like brain fog
• Surveillance of co-infection hotspots such as high-density urban areas

Risks

• Higher odds of co-infection associated with residence area, larger family size, and high population density
• Co-infection increases risk of severe health conditions by over fourfold
• Older age (>50 years) linked to more severe disease manifestations

Patient & Prescribing Data

Individuals aged 10 years and older in Dhaka infected with dengue and/or COVID-19

No specific vaccines for dengue; COVID-19 vaccines available since February 2021 but co-infection remains a significant health threat requiring vigilant clinical management

Clinical Best Practices

• Implement combined diagnostic testing for dengue and COVID-19 in endemic urban settings
• Prioritize monitoring and supportive care for older adults and those with co-infection
• Address social determinants such as population density and household size in public health interventions
• Educate patients on symptom recognition including fever, weakness, chills, and respiratory distress
• Conduct ongoing epidemiological surveillance to identify and respond to co-infection clusters

References

• Clinical Epidemiology of Dengue and COVID-19 Co-infection in Dhaka