Journal Article

Detection of SARS-CoV-2 antibodies in febrile patients from an endemic region of dengue and chikungunya in Peru

Levy-Blitchtein, Saul, del Valle, Luis J., del Valle-Mendoza, Juana, Martins-Luna, Johanna, Cabellos-Altamirano, Felipe, Kym, Sungmin, Tarazona-Castro, Yordi, Troyes-Rivera, Lucinda, Miranda-Maravi, Sebastian, Silva-Caso, Wilmer, Aguilar-Luis, Miguel Angel, Carrillo-Ng, Hugo

2022

Overview

The rapid expansion of the novel SARS-CoV-2 virus has raised serious public health concerns due to the possibility of misdiagnosis in regions where arboviral diseases are endemic. We performed the first study in northern Peru to describe the detection of SARS-CoV-2 IgM antibodies in febrile patients with a suspected diagnosis of dengue and chikungunya fever. A consecutive cross-sectional study was performed in febrile patients attending primary healthcare centers from April 2020 through March 2021. Patients enrolled underwent serum sample collection for the molecular and serological detection of DENV and CHIKV. Also, serological detection of IgM antibodies against SARS-CoV-2 was performed. 464 patients were included during the study period, of which (40.51%) were positive for one pathogen, meanwhile (6.90%) presented co-infections between 2 or more pathogens. The majority of patients with monoinfections were positive for SARS-CoV-2 IgM with (73.40%), followed by DENV 18.09% and CHIKV (8.51%). The most frequent co-infection was DENV + SARS-CoV-2 with (65.63%), followed by DENV + CHIKV and DENV + CHIKV + SARS-CoV-2, both with (12.50%). The presence of polyarthralgias in hands (43.75%, p<0.01) and feet (31.25%, p = 0.05) were more frequently reported in patients with CHIKV monoinfection. Also, conjunctivitis was more common in patients positive for SARS-CoV-2 IgM (11.45%, p<0.01). The rest of the symptoms were similar among all the study groups. SARS-CoV-2 IgM antibodies were frequently detected in acute sera from febrile patients with a clinical suspicion of arboviral disease. The presence of polyarthralgias in hands and feet may be suggestive of CHIKV infection. These results reaffirm the need to consider SARS-CoV-2 infection as a main differential diagnosis of acute febrile illness in arboviruses endemic areas, as well as to consider co-infections between these pathogens.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Antibodies / Antibodies, Viral / Arthralgia / Biology and life sciences / Chikungunya fever / Chikungunya Fever - diagnosis / Chikungunya Fever - epidemiology / Chikungunya virus / Coinfection - diagnosis / Coinfection - epidemiology / Conjunctivitis / Coronaviruses / COVID-19 / COVID-19 - diagnosis / COVID-19 - epidemiology / Cross-Sectional Studies / Dengue / Dengue - diagnosis / Dengue - epidemiology / Dengue fever / Dengue Virus / Diagnosis / Differential diagnosis / Distribution / Environmental aspects / Epidemics / Feet / Fever / Fever - diagnosis / Health care / Humans / Immunoglobulin M / Infections / Medicine and health sciences / Pathogens / Patient outcomes / Patients / Peru / Peru - epidemiology / Public health / Research and Analysis Methods / SARS-CoV-2 / Severe acute respiratory syndrome / Severe acute respiratory syndrome coronavirus 2 / Signs and symptoms / Vector-borne diseases / Viral diseases / Viruses / Zika virus / Zika Virus Infection - epidemiology