5 Discussion:
Coinfections of SARS-CoV-2 with other pathogens have been well-documented [22 - 24], highlighting the need for vigilance in regions prone to multiple infectious diseases like Sudan [25 - 37]. Notably, cases of COVID-19 and Dengue fever coinfection have been reported in areas like Thailand, Singapore and United state of America [38 - 41].
Dengue fever, historically widespread in Africa, is influenced by factors like climate change and urbanization, affecting the Aedes mosquito population and consequently the spread of the dengue virus [13 – 20, 42]. Sudan, being endemic to Dengue fever, faces particular challenges [13 - 20]. Dengue and COVID-19, both viral infections, share similarities, necessitating a high index of suspicion in areas where Dengue is prevalent [43, 44]. Recognizing the overlap in symptoms between non-severe Dengue and COVID-19 poses diagnostic challenges, emphasizing the importance of a rapid and accurate diagnostic strategy, especially during the ongoing COVID-19 pandemic [45, 46].
In the case presented, the patient concurrently had COVID-19 and Dengue fever, which was effectively managed in the COVID-19 unit. While patients co-infected with SARS-CoV-2 and other respiratory viruses exhibit clinical similarities to COVID-19, Dengue fever typically manifests with fever, vomiting, rashes, and body aches, including the ominous sign of blood vomiting [47, 48]. Surprisingly, the platelet count in this case remained within the normal range, contrary to the frequently lowered platelet count reported in COVID-19 and Dengue coinfections [38 – 41, 47,48]. The management of the patient involved a multidisciplinary approach. Treatment included hydration, antibiotic therapy for potential bacterial infections, anticoagulation to prevent clotting issues associated with COVID-19, acid suppression therapy to manage stress ulcers, and antivirals and supplements to support the immune system. Adjustments were made in intravenous fluid management based on hematocrit levels for Dengue Fever.
Monitoring of vital signs, fluid balance, and symptom management were crucial during the patient’s hospital stay. Regular assessment ensured early detection of any complications and guided appropriate interventions. The patient responded well to the treatment provided, with the fever resolving, stable oxygen saturation levels, and no requirement for oxygen therapy or steroids.
Despite the challenges posed by the COVID-19 pandemic, particularly in regions like Sudan and other African countries where data on coinfections are limited, it is crucial to adapt to the evolving situation. It is essential to provide adequate care for patients with multiple infections, considering the limited resources and healthcare systems in developing nations. Collaborative efforts and tailored management strategies are imperative to address the complex interplay of viral infections in such settings.