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Interacting Epidemics in Amazonian Brazil: Prior Dengue Infection Associated With Increased Coronavirus Disease 2019 (COVID-19) Risk in a Population-Based Cohort Study.
Nicolete, Vanessa C; Rodrigues, Priscila T; Johansen, Igor C; Corder, Rodrigo M; Tonini, Juliana; Cardoso, Marly A; de Jesus, Jaqueline G; Claro, Ingra M; Faria, Nuno R; Sabino, Ester C; Castro, Marcia C; Ferreira, Marcelo U.
  • Nicolete VC; Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil.
  • Rodrigues PT; Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil.
  • Johansen IC; Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil.
  • Corder RM; Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil.
  • Tonini J; Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil.
  • Cardoso MA; Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil.
  • de Jesus JG; Institute of Tropical Medicine and Department of Infectious and Parasitic Diseases, Medical School, University of São Paulo, São Paulo, Brazil.
  • Claro IM; Institute of Tropical Medicine and Department of Infectious and Parasitic Diseases, Medical School, University of São Paulo, São Paulo, Brazil.
  • Faria NR; Institute of Tropical Medicine and Department of Infectious and Parasitic Diseases, Medical School, University of São Paulo, São Paulo, Brazil.
  • Sabino EC; Department of Infectious Disease Epidemiology, Imperial College London, ,London, UK.
  • Castro MC; Department of Zoology, University of Oxford, Oxford, UK.
  • Ferreira MU; Institute of Tropical Medicine and Department of Infectious and Parasitic Diseases, Medical School, University of São Paulo, São Paulo, Brazil.
Clin Infect Dis ; 73(11): 2045-2054, 2021 12 06.
Article in English | MEDLINE | ID: covidwho-1560351
ABSTRACT

BACKGROUND:

Immunity after dengue virus (DENV) infection has been suggested to cross-protect from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and mortality.

METHODS:

We tested whether serologically proven prior DENV infection diagnosed in September-October 2019, before the coronavirus disease 2019 (COVID-19) pandemic, reduced the risk of SARS-CoV-2 infection and clinically apparent COVID-19 over the next 13 months in a population-based cohort in Amazonian Brazil. Mixed-effects multiple logistic regression analysis was used to identify predictors of infection and disease, adjusting for potential individual and household-level confounders. Virus genomes from 14 local SARS-CoV-2 isolates were obtained using whole-genome sequencing.

RESULTS:

Anti-DENV immunoglobulin G (IgG) was found in 37.0% of 1285 cohort participants (95% confidence interval [CI] 34.3% to 39.7%) in 2019, with 10.4 (95% CI 6.7-15.5) seroconversion events per 100 person-years during the follow-up. In 2020, 35.2% of the participants (95% CI 32.6% to 37.8%) had anti-SARS-CoV-2 IgG and 57.1% of the 448 SARS-CoV-2 seropositives (95% CI 52.4% to 61.8%) reported clinical manifestations at the time of infection. Participants aged >60 years were twice more likely to have symptomatic COVID-19 than children under 5 years. Locally circulating SARS-CoV-2 isolates were assigned to the B.1.1.33 lineage. Contrary to the cross-protection hypothesis, prior DENV infection was associated with twice the risk of clinically apparent COVID-19 upon SARS-CoV-2 infection, with P values between .025 and .039 after adjustment for identified confounders.

CONCLUSIONS:

Higher risk of clinically apparent COVID-19 among individuals with prior dengue has important public health implications for communities sequentially exposed to DENV and SARS-CoV-2 epidemics.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Dengue / COVID-19 Type of study: Cohort study / Observational study / Prognostic study / Randomized controlled trials Limits: Child / Child, preschool / Humans Country/Region as subject: South America / Brazil 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 / COVID-19 Type of study: Cohort study / Observational study / Prognostic study / Randomized controlled trials Limits: Child / Child, preschool / Humans Country/Region as subject: South America / Brazil Language: English Journal: Clin Infect Dis Journal subject: Communicable Diseases Year: 2021 Document Type: Article Affiliation country: Cid