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.