ABSTRACT
Background : SARs-CoV-2 and DENGUE share clinical symptoms triggering inflammatory processes with high biomarkers levels that can hinder their differentiation in periods of double viral circulation. Aims : To compare levels of D-dimer(DD), High Sentivity C-reactive protein(CRP-H), Ferritin, Lactic-Dehydrogenase(LDH) and haematological parameters among patients with COVID-19 or DENGUE at first hospital consultation in emergency department(FCED). Methods : Retrospective cohort study: consecutive patients (Age > 18y.o.) at FCED on suspicion of symptomatic COVID-19 infection (March-June 2020), in which DD (VIDAS-Exclusion II, Biomerieux) was measured. Only dengue or COVID-19 positive patients were included and classified as Dengue, Mild upper airway infection (MUAI) by COVID-19 and COVID-19 pneumonia. DD(ng/ mL FEU), CRP-H, ferritin and LDH(Beckman-Coulter), PT and APTT(ACLTOP, Instrumentation Laboratory) and haematological parameters( DxH800, Beckman Coulter), were compared. Statistics: SPSS-23 Software Results : A total of 229 patients were included. Non severe Dengue patients presented significantly higher DD levels than MUAI, but not different to COVID-19-positive pneumonia at FCED (Table 1). The leukocytes, neutrophils, lymphocytes, and platelets count(both considering FCED and nadir) were lower in DENGUE, compared to COVID-19 patients (Table 2). CRP-H levels were higher in DENGUE than in Covid-19 MUAI, but lower than COVID-19 pneumonia. DENGUE LDH and ferritin levels were higher than those of MUAI but comparable to those of Covid-19 pneumonia (Table 1). Ferritin and LDH show a statistically correlation to DD in DENGUE and COVID-19-positive patients, but DD and CRP-H only correlated in COVID-19 patients( r :0.567). Platelets correlated negatively( r :-0.437) with DD only in dengue. Dengue patients with platelets nadir<100 × 109/L and elevated liver transaminases have higher DD levels than those with higher platelels count and not liver inflamation. Conclusions : Dengue and COVID-19 infections can trigger inflammatory processes with increased biomarkers, including DD. We showed that in non severe dengue the magnitude of response may be greater than in MUAI and similar to pneumonia COVID-19 positive. Studies are needed to define and compare the prognostic role of biomarkers in these entities.