tetano
Editor, Senior Moderator
Clin Infect Dis
. 2021 May 6;ciab410.
doi: 10.1093/cid/ciab410. Online ahead of print.
Interacting Epidemics in Amazonian Brazil: Prior Dengue Infection Associated with Increased COVID-19 Risk in a Population-Based Cohort Study
Vanessa C Nicolete[SUP] 1 [/SUP], Priscila T Rodrigues[SUP] 1 [/SUP], Igor C Johansen[SUP] 1 [/SUP], Rodrigo M Corder[SUP] 1 [/SUP], Juliana Tonini[SUP] 1 [/SUP], Marly A Cardoso[SUP] 2 [/SUP], Jaqueline G de Jesus[SUP] 3 [/SUP], Ingra M Claro[SUP] 3 [/SUP], Nuno R Faria[SUP] 3 4 5 [/SUP], Ester C Sabino[SUP] 3 [/SUP], Marcia C Castro[SUP] 6 [/SUP], Marcelo U Ferreira[SUP] 1 [/SUP]
Affiliations
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 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 IgG was found in 37.0% of 1,285 cohort participants (95% confidence interval [CI], 34.3% to 39.7%) in 2019, with 10.4 (95% CI, 6.7 to 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 y were twice more likely to have symptomatic COVID-19 than under-five children. 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 0.025 and 0.039 after adjustment for identified confounders.
Conclusion: 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.
Keywords: Amazon; COVID-19; SARS-CoV-2; dengue; genome sequencing; serology.
. 2021 May 6;ciab410.
doi: 10.1093/cid/ciab410. Online ahead of print.
Interacting Epidemics in Amazonian Brazil: Prior Dengue Infection Associated with Increased COVID-19 Risk in a Population-Based Cohort Study
Vanessa C Nicolete[SUP] 1 [/SUP], Priscila T Rodrigues[SUP] 1 [/SUP], Igor C Johansen[SUP] 1 [/SUP], Rodrigo M Corder[SUP] 1 [/SUP], Juliana Tonini[SUP] 1 [/SUP], Marly A Cardoso[SUP] 2 [/SUP], Jaqueline G de Jesus[SUP] 3 [/SUP], Ingra M Claro[SUP] 3 [/SUP], Nuno R Faria[SUP] 3 4 5 [/SUP], Ester C Sabino[SUP] 3 [/SUP], Marcia C Castro[SUP] 6 [/SUP], Marcelo U Ferreira[SUP] 1 [/SUP]
Affiliations
- PMID: 33956939
- DOI: 10.1093/cid/ciab410
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 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 IgG was found in 37.0% of 1,285 cohort participants (95% confidence interval [CI], 34.3% to 39.7%) in 2019, with 10.4 (95% CI, 6.7 to 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 y were twice more likely to have symptomatic COVID-19 than under-five children. 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 0.025 and 0.039 after adjustment for identified confounders.
Conclusion: 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.
Keywords: Amazon; COVID-19; SARS-CoV-2; dengue; genome sequencing; serology.