PDF(Pubmed)
Abstract：
Few studies have investigated whether SARS-CoV-2 infections increase the incidence of dengue haemorrhagic fever/shock syndrome (DHF/DSS) and/or severe dengue (SD) in dengue virus (DENV)-infected patients. This study was performed on a site with high incidences of classical dengue, but relatively few DHF/DSS or SD cases as defined by the WHO 1997 or 2009 criteria, respectively. Clinical, haematological/biochemical, and viral diagnostic data were collected from febrile patients before, during, and after the COVID-19 epidemic to assess whether (a) DENV-infected patients with prior SARS-CoV-2 infections or (b) DENV-SARS-CoV-2-co-infected patients had increased incidences of SD/DHF/DSS using logistic regression and machine learning models. Higher numbers of DHF/DSS/SD occurred during the COVID-19 epidemic, particularly in males and 18-40-year-olds. Significantly increased symptoms in the DENV-SARS-CoV-2-co-infected cases were (a) haemoconcentration (p < 0.0009) and hypotension (p < 0.0005) (DHF/DSS and SD criteria), (b) thrombocytopenia and mucosal bleeding (DHF/DSS-criteria), (c) abdominal pain, persistent vomiting, mucosal bleeding, and thrombocytopenia (SD warning signs) and (d) dyspnoea, but without fluid accumulation. DENV-infected patients with prior SARS-CoV-2 infections had significantly increased incidences of thrombocytopenia (DHF/DSS-criteria) and/or abdominal pain and persistent vomiting and also thrombocytopenia (SD warning signs), but without significant haemoconcentration or hypotension. DENV-SARS-CoV-2 co-infections significantly increased the incidence of DHF/DSS/SD, while DENV-infected patients with prior SARS-CoV-2 infections displayed significantly increased incidences of thrombocytopenia (DHF/DSS-criteria) and three important SD warning signs, which are therefore very important for health workers/clinicians in assessing patients\' DHF/DSS/SD risk factors and planning their optimal therapies.
摘要：
很少有研究调查SARS-CoV-2感染是否会增加登革病毒（DENV）感染患者的登革热出血热/休克综合征（DHF/DSS）和/或严重登革热（SD）的发生率。这项研究是在经典登革热发病率高的地点进行的，但按WHO1997或2009年标准定义的DHF/DSS或SD病例相对较少，分别。临床,血液学/生物化学，病毒的诊断数据是以前从发热患者那里收集的，during,以及在COVID-19流行后，使用逻辑回归和机器学习模型评估(a)先前有SARS-CoV-2感染的DENV感染患者或(b)DENV-SARS-CoV-2共感染患者的SD/DHF/DSS发病率是否增加。在COVID-19流行期间发生了更多的DHF/DSS/SD，尤其是男性和18-40岁的年轻人。DENV-SARS-CoV-2共感染病例的症状显著增加：（a）血液浓缩（p<0.0009）和低血压（p<0.0005）（DHF/DSS和SD标准），（b）血小板减少症和粘膜出血（DHF/DSS标准），(c)腹痛,持续性呕吐,粘膜出血，和血小板减少症（SD警告标志）和（d）呼吸困难，但没有液体积聚。先前有SARS-CoV-2感染的DENV感染患者的血小板减少症（DHF/DSS标准）和/或腹痛和持续性呕吐以及血小板减少症（SD警告信号）的发生率显着增加，但没有明显的血液浓缩或低血压.DENV-SARS-CoV-2共感染显著增加DHF/DSS/SD的发病率,虽然先前有SARS-CoV-2感染的DENV感染患者显示血小板减少症（DHF/DSS标准）和三个重要的SD警告信号的发生率显着增加，因此，这对于卫生工作者/临床医生评估患者的DHF/DSS/SD危险因素和规划其最佳治疗非常重要。
