1 Introduction:
The devastating impact of pandemics is often compounded by the presence of co-infections, which can significantly increase mortality rates [1, 2]. A notable example is the Spanish Flu of 1918, where many deaths were attributed to secondary infections occurring alongside the primary respiratory viral pathogen, leading to more severe outcomes [3]. Fast forward to the recent COVID-19 pandemic caused by SARS-CoV-2, originating in Wuhan, China, similar concerns around co-infections persist [4]. Recent studies indicate that up to 50% of COVID-19-related deaths involve secondary bacterial infections, prompting empirical antimicrobial treatment in a significant percentage of hospitalized patients to mitigate the risk of co-infections, despite challenges posed by antimicrobial resistance [5,6].
In addition to bacterial co-infections, cases of fungal co-infections alongside SARS-CoV-2 have also been documented, highlighting the complexity and challenges associated with managing multiple infections during major respiratory outbreaks [7,8].
It is worth noting the importance of studying and understanding the impact of co-infections, particularly involving viruses from different groups, which remains an area that requires further exploration, especially in the context of major respiratory infection outbreaks [9 - 12]. Moreover, the timing of the COVID-19 outbreak during the monsoon season, when diseases like dengue fever are prevalent in tropical regions, including countries like Sudan [13 - 20], adds another layer of complexity [21]. Dengue fever, transmitted by Aedes mosquitoes and caused by one of four arbovirus serotypes, has been a growing concern due to its rapid spread and impact on public health [15 - 20].
In Sudan specifically, the surge in dengue fever cases in 2023 posed significant public health challenges [9]. Managing cases of simultaneous infections from different virus groups, such as Coronaviruses and Flaviviruses, requires a well-coordinated and effective approach to ensure successful outcomes in such complex scenarios. In this communication we reported on patient who concurrently had COVID-19 and Dengue fever, which was effectively managed in the COVID-19 unit