Dengue, malaria a new threat for Covid patients
Doctors in at least two Delhi hospitals have reported patients with twin infections of Covid-19 and dengue or malaria, a trend that could become worrying since the double disease may be deadlier, and the region is entering its most critical season for mosquito-transmitted diseases.
The anecdotal reports tie in with latest findings that suggest a high prevalence of co-infections of diseases such as malaria, dengue and leptospirosis, which together have several symptoms that overlap with a symptomatic Covid-19 illness.
One such case was that of a 30-year-old patient with malaria who also tested positive for dengue and Covid-19 at Indraprastha Apollo Hospital in Delhi recently, before he eventually succumbed. “We know of dengue and malaria occurring simultaneously in places where there is mosquito breeding. However, because of current protocols, when we tested him for Covid-19, he tested positive. This resulted in complications and he died despite his young age and no comorbidities,” said Dr Rajesh Chawala, senior consulting pulmonologist at the hospital.
At Lok Nayak hospital, a similar case was detected when doctors noticed a drop in the platelet count for a 14-year-old Covid-19 patient. “When we tested him for dengue, he tested positive. This allowed us to manage him for dengue as well. He did not get very severe disease and was discharged about ten days ago,” said Dr Suresh Kumar, medical director, Lok Nayak hospital.
“This is the only case of dengue co-infection that we have recorded, so we do not know whether it will result in complications. Doctors should be on the lookout for other infections as well, even though most of the patients are currently coming in with Covid-19,” said Kumar.
Dengue cases usually begin in July, spike in October before tapering off in November and December. According to civic records, in 2015, as many as 15,867 dengue cases were reported and 60 people died. The number of dengue cases in 2019 was brought down to 2,036 and only two deaths were reported.
The challenge this year is compounded as large portions of the civic staff who normally fan out across the city to detect mosquito breeding spots are now on Covid-19 duty, which includes widespread testing, sanitisation and containment efforts.
A study by researchers at All India Institute of Medical Sciences (AIIMS) Delhi demonstrated a high prevalence or co-infection of malaria with dengue and leptospirosis, a bacterial infection that causes fever, headache, muscle pain and bleeding.
Around 44% of the patients with malaria had dengue, found the study, which was recently published in the journal Emerging Infectious Diseases.
“We started doing this study after we found a few cases where the patient had both malaria and dengue. We had not known there was such high prevalence of co-infections,” said study co-author Dr Pragyan Acharya, associate professor in the department of biochemistry, AIIMS Delhi.
“The other interesting finding of the study was malaria infection from plasmodium knowlesi, which was thought of to be prevalent in countries like Indonesia and Malaysia,” she said. P knowlesi was detected in 12 of the 66 patients included in the study.
“Doctors should not forget that Covid-19 has not replaced the other infections and these diseases should also be considered,” said Acharya.