Dengue and COVID-19 in the context of co-endemic viral illnesses overlapping symptoms, biomarkers, and diagnostic strategies | ||||
| Microbes and Infectious Diseases | ||||
| Articles in Press, Accepted Manuscript, Available Online from 01 September 2025 | ||||
| Document Type: Review Article | ||||
| DOI: 10.21608/mid.2025.386894.2810 | ||||
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| Authors | ||||
Aditi Pal1, 2; Srikant Kumar Dhar3; Monalisa Subudhi4; Mahesh Chandra Sahu   2
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| 1Centre for Biotechnology, Siksha ‘O’ Anusandhan Deemed to be University, Kalinganagar, Bhubaneswar-751003, Odisha, India | ||||
| 2Medical Entomology Division, ICMR-Regional Medical Research Centre, Chandrasekharpur, Bhubaneswar-751023, Odisha, India | ||||
| 3Senior Consultant-General Medicine, SUM Ultimate Medicare, K8 Kalinga Nagar, Ghatikia, Bhubaneswar, Odisha 751003 | ||||
| 4Department of Microbiology, IMS and SUM Hospital II, Phulnakhara, SOA Deemed to be University, Bhubaneswar- 754001, Odisha, India | ||||
| Abstract | ||||
| Background: The concurrent circulation of Dengue, COVID-19, Zika, and Chikungunya poses major diagnostic challenges due to overlapping symptoms like fever, rash, and myalgia. This review examines clinical, laboratory, and epidemiological distinctions to improve differential diagnosis, especially in co-endemic and low-resource regions. Dengue often presents with thrombocytopenia and elevated AST, while COVID-19 shows lymphopenia and high CRP/D-dimer. Zika and Chikungunya have milder lab changes but share clinical features with the others. Misdiagnosis risks include inappropriate treatment (e.g., anticoagulation in Dengue or delayed respiratory support in COVID-19). Serological cross-reactivity, particularly between Dengue and Zika, further complicates diagnosis. Advances like multiplex PCR, CRISPR diagnostics, and AI-driven tools offer promise, though implementation in low-resource settings remains a barrier. Mobile diagnostic units and algorithm-based triage tools enhance access and early outbreak response. Accurate, timely diagnosis is vital for patient care and public health. Integrated strategies combining clinical assessment with scalable, validated point-of-care technologies are key to mitigating co-epidemic impacts and improving healthcare resilience. | ||||
| Keywords | ||||
| Dengue; COVID-19; public health; Diagnosis; Viral Illnesses | ||||
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