Interacting epidemics in Amazonian Brazil: prior dengue infection associated with increased coronavirus disease 2019 (COVID-19) risk in a population-based cohort study
Author(s)
Type
Journal Article
Abstract
Background
Immunity after dengue virus (DENV) infection has been suggested to cross-protect from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and mortality.
Methods
We tested whether serologically proven prior DENV infection diagnosed in September–October 2019, before the coronavirus disease 2019 (COVID-19) pandemic, reduced the risk of SARS-CoV-2 infection and clinically apparent COVID-19 over the next 13 months in a population-based cohort in Amazonian Brazil. Mixed-effects multiple logistic regression analysis was used to identify predictors of infection and disease, adjusting for potential individual and household-level confounders. Virus genomes from 14 local SARS-CoV-2 isolates were obtained using whole-genome sequencing.
Results
Anti-DENV immunoglobulin G (IgG) was found in 37.0% of 1285 cohort participants (95% confidence interval [CI]: 34.3% to 39.7%) in 2019, with 10.4 (95% CI: 6.7–15.5) seroconversion events per 100 person-years during the follow-up. In 2020, 35.2% of the participants (95% CI: 32.6% to 37.8%) had anti-SARS-CoV-2 IgG and 57.1% of the 448 SARS-CoV-2 seropositives (95% CI: 52.4% to 61.8%) reported clinical manifestations at the time of infection. Participants aged >60 years were twice more likely to have symptomatic COVID-19 than children under 5 years. Locally circulating SARS-CoV-2 isolates were assigned to the B.1.1.33 lineage. Contrary to the cross-protection hypothesis, prior DENV infection was associated with twice the risk of clinically apparent COVID-19 upon SARS-CoV-2 infection, with P values between .025 and .039 after adjustment for identified confounders.
Conclusions
Higher risk of clinically apparent COVID-19 among individuals with prior dengue has important public health implications for communities sequentially exposed to DENV and SARS-CoV-2 epidemics.
Immunity after dengue virus (DENV) infection has been suggested to cross-protect from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and mortality.
Methods
We tested whether serologically proven prior DENV infection diagnosed in September–October 2019, before the coronavirus disease 2019 (COVID-19) pandemic, reduced the risk of SARS-CoV-2 infection and clinically apparent COVID-19 over the next 13 months in a population-based cohort in Amazonian Brazil. Mixed-effects multiple logistic regression analysis was used to identify predictors of infection and disease, adjusting for potential individual and household-level confounders. Virus genomes from 14 local SARS-CoV-2 isolates were obtained using whole-genome sequencing.
Results
Anti-DENV immunoglobulin G (IgG) was found in 37.0% of 1285 cohort participants (95% confidence interval [CI]: 34.3% to 39.7%) in 2019, with 10.4 (95% CI: 6.7–15.5) seroconversion events per 100 person-years during the follow-up. In 2020, 35.2% of the participants (95% CI: 32.6% to 37.8%) had anti-SARS-CoV-2 IgG and 57.1% of the 448 SARS-CoV-2 seropositives (95% CI: 52.4% to 61.8%) reported clinical manifestations at the time of infection. Participants aged >60 years were twice more likely to have symptomatic COVID-19 than children under 5 years. Locally circulating SARS-CoV-2 isolates were assigned to the B.1.1.33 lineage. Contrary to the cross-protection hypothesis, prior DENV infection was associated with twice the risk of clinically apparent COVID-19 upon SARS-CoV-2 infection, with P values between .025 and .039 after adjustment for identified confounders.
Conclusions
Higher risk of clinically apparent COVID-19 among individuals with prior dengue has important public health implications for communities sequentially exposed to DENV and SARS-CoV-2 epidemics.
Date Issued
2021-12-01
Date Acceptance
2021-04-27
Citation
Clinical Infectious Diseases, 2021, 73 (11), pp.2045-2054
ISSN
1058-4838
Publisher
Oxford University Press
Start Page
2045
End Page
2054
Journal / Book Title
Clinical Infectious Diseases
Volume
73
Issue
11
Copyright Statement
Copyright © 2021 Oxford University Press. This is a pre-copy-editing, author-produced version of an article accepted for publication in Clinical Infectious Diseases following peer review. The definitive publisher-authenticated version Vanessa C Nicolete, Priscila T Rodrigues, Igor C Johansen, Rodrigo M Corder, Juliana Tonini, Marly A Cardoso, Jaqueline G de Jesus, Ingra M Claro, Nuno R Faria, Ester C Sabino, Marcia C Castro, Marcelo U Ferreira, Interacting Epidemics in Amazonian Brazil: Prior Dengue Infection Associated With Increased Coronavirus Disease 2019 (COVID-19) Risk in a Population-Based Cohort Study, Clinical Infectious Diseases, Volume 73, Issue 11, 1 December 2021, Pages 2045–2054 is available online at: https://doi.org/10.1093/cid/ciab410
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000755559200014&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
PII: 6270997
Subjects
COVID-19
dengue
genome sequencing
Immunology
Infectious Diseases
Life Sciences & Biomedicine
Microbiology
SARS-CoV-2
Science & Technology
serology
VIRUS-INFECTION
Publication Status
Published
Coverage Spatial
United States
Date Publish Online
2021-05-06