Distinguishing non severe cases of dengue from COVID-19 in the context of co-epidemics: A cohort study in a SARS-CoV-2 testing center on Reunion island

Background As coronavirus 2019 (COVID-19) is spreading globally, several countries are handling dengue epidemics. As both infections are deemed to share similarities at presentation, it would be useful to distinguish COVID-19 from dengue in the context of co-epidemics. Hence, we performed a retrospective cohort study to identify predictors of both infections. Methodology/Principal findings All the subjects suspected of COVID-19 between March 23 and May 10, 2020, were screened for COVID-19 within the testing center of the University hospital of Saint-Pierre, Reunion island. The screening consisted in a questionnaire surveyed in face-to-face, a nasopharyngeal swab specimen for the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) reverse transcription polymerase chain-reaction and a rapid diagnostic orientation test for dengue. Factors independently associated with COVID-19 or with dengue were sought using multinomial logistic regression models, taking other febrile illnesses (OFIs) as controls. Adjusted Odds ratios (OR) and 95% Confidence Intervals (95%CI) were assessed. Over a two-month study period, we diagnosed 80 COVID-19, 61 non-severe dengue and 872 OFIs cases eligible to multivariate analysis. Among these, we identified delayed presentation (>3 days) since symptom onset (Odds ratio 1.91, 95% confidence interval 1.07–3.39), contact with a COVID-19 positive case (OR 3.81, 95%CI 2.21–6.55) and anosmia (OR 7.80, 95%CI 4.20–14.49) as independent predictors of COVID-19, body ache (OR 6.17, 95%CI 2.69–14.14), headache (OR 5.03, 95%CI 1.88–13.44) and retro-orbital pain (OR 5.55, 95%CI 2.51–12.28) as independent predictors of dengue, while smoking was less likely observed with COVID-19 (OR 0.27, 95%CI 0.09–0.79) and upper respiratory tract infection symptoms were associated with OFIs. Conclusions/Significance Although prone to potential biases, these data suggest that non-severe dengue may be more symptomatic than COVID-19 in a co-epidemic setting with higher dengue attack rates. At clinical presentation, nine basic clinical and epidemiological indicators may help to distinguish COVID-19 or dengue from each other and other febrile illnesses.

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Distinguishing non severe cases of dengue from COVID-19 in the context of co-epidemics: a cohort study in a SARS-CoV-2 testing center on Reunion island

10.1101/2020.10.20.20214718 ◽

2020 ◽

Author(s):

Antoine Joubert ◽

Fanny Andry ◽

Antoine Bertolotti ◽

Frédéric Accot ◽

Yatrika Koumar ◽

...

Keyword(s):

Cohort Study ◽

Multinomial Logistic Regression ◽

University Hospital ◽

Severe Dengue ◽

Delayed Presentation ◽

Reunion Island ◽

Orbital Pain ◽

Réunion Island ◽

Testing Center ◽

Body Ache

AbstractBackgroundAs coronavirus (COVID-19) is spreading globally, several countries are handling dengue epidemics. As both infections are deemed to share similarities at presentation, it would be useful to distinguish COVID-19 from dengue in the context of co-epidemics. In this aim, we performed a cohort study to identify predictors of both infections.MethodsAll the subjects suspected of COVID-19 between March 23 and May 10, 2020, were screened for COVID-19 within the testing center of the University hospital of Saint-Pierre, Reunion island. The screening consisted in a questionnaire surveyed in face-to-face, a nasopharyngeal swab specimen for the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) reverse transcription polymerase chain-reaction and a rapid diagnostic orientation test for dengue. Factors independently associated with COVID-19 or with dengue were sought using multinomial logistic regression models, taking other febrile illnesses (OFIs) as controls.ResultsOver a two-month study period, we identified among 80 COVID-19, 60 non-severe dengue and 872 OFIs cases, delayed presentation (>3 days) since symptom onset (Odds ratio 1.89, 95% confidence interval 1.4-3.40), contact with a COVID-19 positive case (OR 3.81, 95%CI 2.12-6.82) and anosmia (OR 8.27, 95%CI 4.39-15.54) as independent predictors of COVID-19, body ache (OR 6.83, 95%CI 2.84-16.41), headache (OR 5.38, 95%CI 1.81-15.94) and retro-orbital pain (OR 7.45, 95%CI 3.17-17.50) as independent predictors of dengue, while smoking was less likely observed with COVID-19 (OR 0.27, 95%CI 0.10-0.74).ConclusionsAlthough prone to potential biases, these data suggest that non-severe dengue may be more symptomatic than COVID-19 in a co-epidemic setting with higher dengue attack rates.40-word summary of the article’s main pointIn the COVID-19 dengue co-epidemic setting of Reunion island, dengue was found more symptomatic than COVID-19 and associated with body ache, headache and retro-orbital pain, while COVID-19 was found associated with contact, anosmia, delayed presentation and absence of active smoking.

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Differentiating COVID-19 and dengue from other febrile illnesses in co-epidemics: Development and internal validation of COVIDENGUE scores

10.1101/2021.10.14.21264897 ◽

2021 ◽

Author(s):

Patrick Gerardin ◽

Olivier Maillard ◽

Lea Bruneau ◽

Frederic Accot ◽

Florian Legrand ◽

...

Keyword(s):

Goodness Of Fit ◽

Multinomial Logistic Regression ◽

Characteristic Curve ◽

Severe Dengue ◽

Delayed Presentation ◽

Upper Respiratory Tract ◽

Discriminative Ability ◽

Internal Validation ◽

Logistic Regression Models ◽

Testing Center

Background. In a retrospective cohort study, we previously distinguished the factors associated with coronavirus 2019 (COVID-19) or dengue from those associated with other febrile illnesses (OFIs). In this study, we developed a scoring system to discriminate both infectious diseases. Methods. Predictors of both infections were sought using multinomial logistic regression models (OFIs as controls) in all subjects suspected of COVID-19 who attended the SARS-CoV-2 testing center of Saint-Pierre teaching hospital, Reunion Island, between March 23 and May 10, 2020. Two COVIDENGUE scores were developed and internally validated by bootstrapping for predicting each infection after weighting the odd ratios according to a predefined rule. The discriminative ability of each score was assessed using the area under the receiver operating characteristic curve (AUC). Their calibration was assessed using goodness-of-fit statistics. Results. Over 49 days, 80 COVID-19, 60 non-severe dengue and 872 OFI cases were diagnosed. The translation of the best fit model yielded two COVIDENGUE scores composed of 11 criteria: contact with a COVID-19 positive case (+3 points for COVID-19; 0 point for dengue), return from travel abroad within 15 days (+3/-1), previous individual episode of dengue (+1/+3), active smoking (-3/0), body ache (0/+5), cough (0/-2), upper respiratory tract infection symptoms (-1/-1), anosmia (+7/-1), headache (0/+5), retro-orbital pain (-1/+5), and delayed presentation (>3 days) to hospital (+1/0). The AUC was of 0.79 (95%CI 0.76-0.82) for COVID-19 score and of 0.88 (95%CI 0.85-0.90) for dengue score. Calibration was satisfactory for COVID-19 score and excellent for dengue score. For predicting COVID-19, sensitivity was of 97% at the 0-point cut-off and specificity approximated 99% at the 10-point cut-off. For predicting dengue, sensitivity approximated 97% at the 3-point cut-off and specificity 98% at the 11-point cut-off. Conclusions. In conclusion, the COVIDENGUE scores proved discriminant to differentiate COVID-19 and dengue from other febrile illnesses in the context of SARS-CoV-2 testing center during a co-epidemic. Further studies are needed to validate or refine these scores in other settings.

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Prognosis of Critically Ill Patients With Acute Respiratory Failure Due To The SARS-CoV-2 501Y.V2 Variant: A Multicenter Retrospective Matched Cohort Study

10.21203/rs.3.rs-806080/v2 ◽

2021 ◽

Author(s):

Bérénice Puech ◽

Antoine Legrand ◽

Olivier Simon ◽

Chloé Combe ◽

Marie-Christine Jaffar-Bandjee ◽

...

Keyword(s):

Cohort Study ◽

Respiratory Failure ◽

Acute Respiratory Failure ◽

Invasive Mechanical Ventilation ◽

University Hospital ◽

Original Strain ◽

Reunion Island ◽

Matched Cohort ◽

Matched Cohort Study ◽

Réunion Island

Abstract Background The aim of this study was to compare the prognosis of patients with acute respiratory failure (ARF) due to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant 501Y.V2 to that of patients with ARF due to the original strain. Methods This retrospective matched cohort study included all consecutive patients who were hospitalized for ARF due to SARS-CoV-2 in Reunion Island University Hospital between March 2020 and March 2021. Twenty-eight in hospital mortality was evaluated before and after matching. Results A total of 218 patients with ARF due to SARS-CoV-2 were enrolled in the study. Of these, 83 (38.1%) were infected with the 501Y.V2 variant. During intensive care unit stay, 104 (47.7%) patients received invasive mechanical ventilation and 20 (9.2%) patients were supported by venovenous extracorporeal membrane oxygenation. Patients infected with the 501Y.V2 variant were younger (58 [51–68] vs. 67 [56–74] years old, P = 0.003), had less hypertension (54.2% vs 68.1%, P = 0.04), and had less chronic kidney disease (13.3% vs. 31.9%, P = 0.002) than patients infected with the original strain. After controlling for confounding variables (62 matched patients in each group), 28-day mortality was higher in the group of patients infected with the 501Y.V2 variant (30.6%) than in the group of patients infected with the original strain (19.4%, P = 0.04). Conclusion In Reunion Island, where SARS-CoV-2 incidence remained low until February 2021 and the health care system was never saturated, mortality was higher in patients with ARF infected with the 501Y.V2 variant than in patients infected with the original strain.

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Prognosis of Critically Ill Patients with Acute Respiratory Failure Due to the SARS-CoV-2 501Y.V2 Variant: A Multicenter Retrospective Matched Cohort Study

10.21203/rs.3.rs-806080/v1 ◽

2021 ◽

Author(s):

bérénice Puech ◽

Antoine legrand ◽

Olivier Simon ◽

Chloe Combe ◽

marie-christine jaffarbandjee ◽

...

Keyword(s):

Cohort Study ◽

Respiratory Failure ◽

Acute Respiratory Failure ◽

Invasive Mechanical Ventilation ◽

University Hospital ◽

Original Strain ◽

Reunion Island ◽

Matched Cohort ◽

Matched Cohort Study ◽

Réunion Island

Abstract Background: The aim of this study was to compare the prognosis of patients with acute respiratory failure (ARF) due to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant 501Y.V2 to that of patients with ARF due to the original strain. Methods: This retrospective matched cohort study included all consecutive patients who were hospitalized for ARF due to SARS-CoV-2 in Reunion Island University Hospital between March 2020 and March 2021. Twenty-eight in hospital mortality was evaluated before and after matching.Results: A total of 218 patients with ARF due to SARS-CoV-2 were enrolled in the study. Of these, 83 (38.1%) were infected with the 501Y.V2 variant. During intensive care unit stay, 104 (47.7%) patients received invasive mechanical ventilation and 20 (9.2%) patients were supported by venovenous extracorporeal membrane oxygenation. Patients infected with the 501Y.V2 variant were younger (58 [51-68] vs. 67 [56-74] years old, P=0.003), had less hypertension (54.2% vs 68.1%, P=0.04), and had less chronic kidney disease (13.3% vs. 31.9%, P=0.002) than patients infected with the original strain. After controlling for confounding variables (62 matched patients in each group), 28-day mortality was higher in the group of patients infected with the 501Y.V2 variant (30.6%) than in the group of patients infected with the original strain (19.4%, P=0.04).Conclusion: In Reunion Island, where SARS-CoV-2 incidence remained low until February 2021 and the health care system was never saturated, mortality was higher in patients with ARF infected with the 501Y.V2 variant than in patients infected with the original strain.

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Case Report: Transmission of Dengue Virus from a Deceased Donor to a Kidney Transplant Recipient Previously Infected by Dengue Virus

American Journal of Tropical Medicine and Hygiene ◽

10.4269/ajtmh.21-0137 ◽

2021 ◽

Author(s):

Arnaud Lecadieu ◽

Laura Teysseyre ◽

Kevin Larsen ◽

Charles Vidal ◽

Margot Caron ◽

...

Keyword(s):

Virus Infection ◽

Dengue Virus ◽

Kidney Transplant ◽

Kidney Transplant Recipient ◽

Deceased Donor ◽

Severe Dengue ◽

Reunion Island ◽

Dengue Virus Infection ◽

First Case ◽

Réunion Island

Since 2018, a dengue epidemic has been ongoing in the French overseas department of Reunion Island, in the Indian Ocean, with more than 25,000 serologically confirmed cases. Currently, three dengue serotypes have been identified in Réunion Island (DENV-1, DENV-2, and DENV-3) progressing in the form of epidemic outbreaks. This arbovirus is mainly transmitted by mosquitoes of the genus Aedes and may be responsible for serious clinical forms. To date, very few cases of kidney transplant–related dengue virus infection have been described. Here we report the first case of severe dengue virus infection related to kidney transplantation from a patient previously infected with dengue. Testing for dengue fever with PCR search in donor’s urine may help complete the pretransplant assessment in areas where this disease occurs.

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Candidemia in the intensive care unit: A 12-year retrospective cohort study in Reunion Island

Médecine et Maladies Infectieuses ◽

10.1016/j.medmal.2018.04.392 ◽

2018 ◽

Vol 48 (6) ◽

pp. 414-418 ◽

Cited By ~ 2

Author(s):

G. Hoarau ◽

S. Picot ◽

J. Lemant ◽

J. Peytral ◽

P. Poubeau ◽

...

Keyword(s):

Intensive Care Unit ◽

Cohort Study ◽

Intensive Care ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Reunion Island ◽

Réunion Island

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Obstetric and neonatal outcomes of adolescent primiparous singleton pregnancies: a cohort study in the South of Reunion Island, Indian Ocean

The Journal of Maternal-Fetal & Neonatal Medicine ◽

10.3109/14767058.2012.718003 ◽

2012 ◽

Vol 25 (12) ◽

pp. 2591-2596 ◽

Cited By ~ 13

Author(s):

Silvia Iacobelli ◽

Pierre-Yves Robillard ◽

Jean-Bernard Gouyon ◽

Thomas C. Hulsey ◽

Georges Barau ◽

...

Keyword(s):

Cohort Study ◽

Indian Ocean ◽

Neonatal Outcomes ◽

Reunion Island ◽

The South ◽

Réunion Island ◽

Singleton Pregnancies

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Neurocognitive Outcome of Children Exposed to Perinatal Mother-to-Child Chikungunya Virus Infection: The CHIMERE Cohort Study on Reunion Island

PLoS Neglected Tropical Diseases ◽

10.1371/journal.pntd.0002996 ◽

2014 ◽

Vol 8 (7) ◽

pp. e2996 ◽

Cited By ~ 111

Author(s):

Patrick Gérardin ◽

Sylvain Sampériz ◽

Duksha Ramful ◽

Brahim Boumahni ◽

Marc Bintner ◽

...

Keyword(s):

Cohort Study ◽

Virus Infection ◽

Chikungunya Virus ◽

Reunion Island ◽

Neurocognitive Outcome ◽

Réunion Island ◽

Mother To Child

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Instability of the NS1 Glycoprotein from La Reunion 2018 Dengue 2 Virus (Cosmopolitan-1 Genotype) in Huh7 Cells Is Due to Lysine Residues on Positions 272 and 324

International Journal of Molecular Sciences ◽

10.3390/ijms22041951 ◽

2021 ◽

Vol 22 (4) ◽

pp. 1951

Author(s):

Eva Ogire ◽

Olivier Diaz ◽

Pierre-Olivier Vidalain ◽

Vincent Lotteau ◽

Philippe Desprès ◽

...

Keyword(s):

Clinical Manifestations ◽

Severe Dengue ◽

Reunion Island ◽

La Réunion ◽

South West Indian Ocean ◽

Huh7 Cells ◽

Virus Serotype ◽

Lysine Residues ◽

Réunion Island ◽

La Réunion Island

La Reunion island in the South West Indian Ocean is now endemic for dengue following the introduction of dengue virus serotype 2 (DENV-2) cosmopolitan-I genotype in 2017. DENV-2 infection causes a wide spectrum of clinical manifestations ranging from flu-like disease to severe dengue. The nonstructural glycoprotein 1 (NS1) has been identified as playing a key role in dengue disease severity. The intracellular NS1 exists as a homodimer, whereas a fraction is driven towards the plasma membrane or released as a soluble hexameric protein. Here, we characterized the NS1 glycoproteins from clinical isolates DES-14 and RUN-18 that were collected during the DENV-2 epidemics in Tanzania in 2014 and La Reunion island in 2018, respectively. In relation to hepatotropism of the DENV, expression of recombinant DES-14 NS1 and RUN-18 NS1 glycoproteins was compared in human hepatoma Huh7 cells. We observed that RUN-18 NS1 was poorly stable in Huh7 cells compared to DES-14 NS1. The instability of RUN-18 NS1 leading to a low level of NS1 secretion mostly relates to lysine residues on positions 272 and 324. Our data raise the issue of the consequences of a defect in NS1 stability in human hepatocytes in relation to the major role of NS1 in the pathogenesis of the DENV-2 infection.

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