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Potential Antigenic Cross-reactivity Between Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and Dengue Viruses.
Lustig, Yaniv; Keler, Shlomit; Kolodny, Rachel; Ben-Tal, Nir; Atias-Varon, Danit; Shlush, Ekaterina; Gerlic, Motti; Munitz, Ariel; Doolman, Ram; Asraf, Keren; Shlush, Liran I; Vivante, Asaf.
  • Lustig Y; Central Virology Laboratory, Ministry of Health, Chaim Sheba Medical Center, Ramat Gan, Israel.
  • Keler S; Department of Pediatrics B, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat-Gan, Israel.
  • Kolodny R; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
  • Ben-Tal N; Department of Computer Science, University of Haifa, Mount Carmel, Israel.
  • Atias-Varon D; Department of Biochemistry and Molecular Biochemistry, George S. Wise Faculty of Life Sciences, Tel Aviv University, Tel-Aviv, Israel.
  • Shlush E; Department of Pediatrics B, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat-Gan, Israel.
  • Gerlic M; IVF Unit Department of Obstetric and Gynecology Galilee Medical Center, Naharia, Israel.
  • Munitz A; Department of Clinical Microbiology and Immunology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
  • Doolman R; Department of Clinical Microbiology and Immunology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
  • Asraf K; The Dworman Automated-Mega Laboratory, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel.
  • Shlush LI; The Mina and Everard Goodman Faculty of Life Sciences, Bar-Ilan University, Ramat-Gan, Israel.
  • Vivante A; The Dworman Automated-Mega Laboratory, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel.
Clin Infect Dis ; 73(7): e2444-e2449, 2021 10 05.
Article in English | MEDLINE | ID: covidwho-1455256
ABSTRACT

BACKGROUND:

Coronavirus disease 2019 (COVID-19) and dengue fever are difficult to distinguish given shared clinical and laboratory features. Failing to consider COVID-19 due to false-positive dengue serology can have serious implications. We aimed to assess this possible cross-reactivity.

METHODS:

We analyzed clinical data and serum samples from 55 individuals with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. To assess dengue serology status, we used dengue-specific antibodies by means of lateral-flow rapid test, as well as enzyme-linked immunosorbent assay (ELISA). Additionally, we tested SARS-CoV-2 serology status in patients with dengue and performed in-silico protein structural analysis to identify epitope similarities.

RESULTS:

Using the dengue lateral-flow rapid test we detected 12 positive cases out of the 55 (21.8%) COVID-19 patients versus zero positive cases in a control group of 70 healthy individuals (P = 2.5E-5). This includes 9 cases of positive immunoglobulin M (IgM), 2 cases of positive immunoglobulin G (IgG), and 1 case of positive IgM as well as IgG antibodies. ELISA testing for dengue was positive in 2 additional subjects using envelope protein directed antibodies. Out of 95 samples obtained from patients diagnosed with dengue before September 2019, SARS-CoV-2 serology targeting the S protein was positive/equivocal in 21 (22%) (16 IgA, 5 IgG) versus 4 positives/equivocal in 102 controls (4%) (P = 1.6E-4). Subsequent in-silico analysis revealed possible similarities between SARS-CoV-2 epitopes in the HR2 domain of the spike protein and the dengue envelope protein.

CONCLUSIONS:

Our findings support possible cross-reactivity between dengue virus and SARS-CoV-2, which can lead to false-positive dengue serology among COVID-19 patients and vice versa. This can have serious consequences for both patient care and public health.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Dengue Virus / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: Clin Infect Dis Journal subject: Communicable Diseases Year: 2021 Document Type: Article Affiliation country: Cid

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Dengue Virus / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: Clin Infect Dis Journal subject: Communicable Diseases Year: 2021 Document Type: Article Affiliation country: Cid