Effects of Recent Prior Dengue Infection on Risk and Severity of Subsequent SARS-CoV-2 Infection: A Retrospective Cohort Study.

Publication date: Aug 01, 2024

Elucidating whether prior dengue potentially confers cross-protection against COVID-19 is of public health importance in tropical countries at risk of overlapping dengue and COVID-19 epidemics. However, studies to date have yielded conflicting results. We aimed to assess effects of recent prior dengue infection on risk and severity of subsequent SARS-CoV-2 infection among adult Singaporeans. A retrospective cohort study including all adult Singaporeans aged ≥18 years was conducted from 1 July 2021 through 31 October 2022, when a dengue outbreak driven by the DENV3 serotype preceded subsequent waves of SARS-CoV-2 Delta/Omicron transmission in Singapore. SARS-CoV-2 and dengue infection status were classified using national registries. Cox regression models adjusted for demographics, COVID-19 vaccination status, comorbidity, and socioeconomic-status were used to assess risks and severity (hospitalization, severe illness) of SARS-CoV-2 infection occurring after previous recorded dengue infection. A total of 3 366 399 individuals were included, contributing 1 399 696 530 person-days of observation. A total of 13 434 dengue infections and 1 253 520 subsequent SARS-CoV-2 infections were recorded; with an average of 94. 7 days (standard deviation = 83. 8) between dengue infection and SARS-CoV-2 infection. Preceding dengue infection was associated with a modest increase in risk of subsequent SARS-CoV-2 infection (adjusted hazards ratio [aHR] = 1. 13; 95% confidence interval [CI], 1. 08-1. 17), and significantly elevated risk of subsequent COVID-19 hospitalization (aHR = 3. 25; 95% CI, 2. 78-3. 82) and severe COVID-19 (aHR = 3. 39; 95% CI, 2. 29-5. 03). Increased risk of SARS-CoV-2 infection and adverse COVID-19 outcomes were observed following preceding dengue infection in a national population-based cohort of adult Singaporeans. This observation is of significance in tropical countries with overlapping dengue and COVID-19 outbreaks.

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Concepts Keywords
Dengue COVID-19
Hospitalization dengue
July Omicron
Models SARS-CoV-2
vaccination

Semantics

Type Source Name
disease MESH Dengue
disease MESH Infection
disease MESH SARS-CoV-2 Infection
pathway REACTOME SARS-CoV-2 Infection
disease VO vaccination
disease MESH comorbidity
disease VO population
drug DRUGBANK Troleandomycin
disease MESH Infectious Diseases
drug DRUGBANK Methylphenidate
drug DRUGBANK Coenzyme M
disease VO Optaflu
disease MESH vaccine breakthrough infections
disease VO vaccinated
disease VO dose
disease VO vaccine
disease IDO symptom
disease IDO assay
disease IDO history
disease MESH reinfection
disease MESH coinfection

Original Article

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