Covid-19 and dengue: Double punches for dengue-endemic countries in Asia

Harapan Harapan, Mirza Ryan, Benediktus Yohan, Rufika Shari Abidin, Firzan Nainu, Ahmed Rakib, Israt Jahan, Talha Bin Emran, Irfan Ullah, Kritu Panta, Kuldeep Dhama, R. Tedjo Sasmono

Research output: Contribution to journalReview articlepeer-review

98 Citations (Scopus)


The coronavirus disease 2019 (Covid-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is an international public health crisis with devastating effects. In particular, this pandemic has further exacerbated the burden in tropical and subtropical regions of the world, where dengue fever, caused by dengue virus (DENV), is already endemic to the population. The similar clinical manifestations shared by Covid-19 and dengue fever have raised concerns, especially in dengue-endemic countries with limited resources, leading to diagnostic challenges. In addition, cross-reactivity of the immune responses in these infections is an emerging concern, as pre-existing DENV-antibodies might potentially affect Covid-19 through antibody-dependent enhancement. In this review article, we aimed to raise the issue of Covid-19 and dengue fever misdiagnosis, not only in a clinical setting but also with regards to cross-reactivity between SARS-CoV-2 and DENV antibodies. We also have discussed the potential consequences of overlapping immunological cascades between dengue and Covid-19 on disease severity and vaccine development.

Original languageEnglish
Article numbere2161
JournalReviews in Medical Virology
Issue number2
Early online date18 Sept 2020
Publication statusPublished - Mar 2021


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