Dengue With COVID-19: Associated With Co-infection and Multiple Organ Dysfunction in a Child

Abstract

Coronavirus disease 2019 (COVID-19), due to SARS-CoV-2 infection, has been a global concern since January 2020. Southeast Asia, including Bangladesh, is facing outbreaks of endemic diseases such as dengue. Here, we report the case of an eight-year-old female from Dhaka with high-grade, continued fever, shock, features of pneumonia, and plasma leakage with multiple organ dysfunction. Both nonstructural protein 1 antigen (NS1 Ag) for dengue and reverse transcription-polymerase chain reaction (RT-PCR) for COVID-19 were positive in the patient. The echocardiographic evaluation showed coronary arterial dilatations. The patient was managed according to the WHO guidelines for dengue with immunoglobulin, methylprednisolone, and aspirin for the involvement of coronary arteries. The patient required a mechanical ventilator due to pulmonary hemorrhage and unstable vitals. She showed gradual improvement with timely managements. Although a single case report does not portray the full picture, through this case report, we aim to describe the severity of co-infection of the mentioned viruses in a child in Bangladesh during the pandemic of SARS-CoV-2. Without appropriate diagnosis and management, it can be fatal.

Keywords: co-infection with dengue and covid-19; covid-19 in children; dengue with sars-cov-2; sars-cov-2; severe dengue.