Covert cases of severe acute respiratory syndrome Coronavirus 2
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10362/116648 |
Resumo: | BACKGROUND: The impact of SARS-CoV-2 in regions endemic for both Dengue and Chikungunya is still not fully understood. Considering that symptoms/clinical features displayed during Dengue, Chikungunya and SARS-CoV-2 acute infections are similar, undiagnosed cases of SARS-CoV-2 in co-endemic areas may be more prevalent than expected. This study was conducted to assess the prevalence of covert cases of SARS-CoV-2 among samples from patients with clinical symptoms compatible with either Dengue or Chikungunya viral infection in the state of Espírito Santo, Brazil. METHODS: Presence of immunoglobulin G (IgG) antibody specific to SARS-CoV-2 nucleoprotein was detected using a chemiluminescent microparticle immunoassay in samples from 7,370 patients, without previous history of COVID-19 diagnosis, suspected of having either Dengue (n = 1,700) or Chikungunya (n = 7,349) from December 1st, 2019 to June 30th, 2020. FINDINGS: Covert cases of SARS-CoV-2 were detected in 210 (2.85%) out of the 7,370 serum samples tested. The earliest undiagnosed missed case of COVID-19 dated back to a sample collected on December 18, 2019, also positive for Dengue Virus. Cross-reactivity with either Dengue virus or other common coronaviruses were not observed. INTERPRETATION: Our findings demonstrate that concomitant Dengue or Chikungunya outbreaks may difficult the diagnosis of SARS-CoV-2 infections. To our knowledge, this is the first study to demonstrate, with a robust sample size (n = 7,370) and using highly specific and sensitive chemiluminescent microparticle immunoassay method, that covert SARS-CoV-2 infections are more frequent than previously expected in Dengue and Chikungunya hyperendemic regions. Moreover, our results suggest that SAR-CoV-2 cases were occurring prior to February, 2020, and that these undiagnosed missed cases may have contributed to the fast expansion of SARS-CoV-2 outbreak in Brazil. Data presented here demonstrate that in arboviral endemic regions, SARS-CoV-2 infection must be always considered, regardless of the existence of a previous positive diagnosis for Dengue or Chikungunya. |
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Covert cases of severe acute respiratory syndrome Coronavirus 2an obscure but present danger in regions endemic for Dengue and Chikungunya virusesAdultAntibodies, Viral/bloodBrazil/epidemiologyCOVID-19/complicationsChikungunya Fever/epidemiologyChikungunya virus/pathogenicityCoinfection/epidemiologyDengue/epidemiologyDengue Virus/pathogenicityDiagnostic Errors/trendsDisease OutbreaksFemaleHumansImmunoglobulin G/bloodMaleMiddle AgedPrevalenceSARS-CoV-2/pathogenicityInfectious DiseasesSDG 3 - Good Health and Well-beingBACKGROUND: The impact of SARS-CoV-2 in regions endemic for both Dengue and Chikungunya is still not fully understood. Considering that symptoms/clinical features displayed during Dengue, Chikungunya and SARS-CoV-2 acute infections are similar, undiagnosed cases of SARS-CoV-2 in co-endemic areas may be more prevalent than expected. This study was conducted to assess the prevalence of covert cases of SARS-CoV-2 among samples from patients with clinical symptoms compatible with either Dengue or Chikungunya viral infection in the state of Espírito Santo, Brazil. METHODS: Presence of immunoglobulin G (IgG) antibody specific to SARS-CoV-2 nucleoprotein was detected using a chemiluminescent microparticle immunoassay in samples from 7,370 patients, without previous history of COVID-19 diagnosis, suspected of having either Dengue (n = 1,700) or Chikungunya (n = 7,349) from December 1st, 2019 to June 30th, 2020. FINDINGS: Covert cases of SARS-CoV-2 were detected in 210 (2.85%) out of the 7,370 serum samples tested. The earliest undiagnosed missed case of COVID-19 dated back to a sample collected on December 18, 2019, also positive for Dengue Virus. Cross-reactivity with either Dengue virus or other common coronaviruses were not observed. INTERPRETATION: Our findings demonstrate that concomitant Dengue or Chikungunya outbreaks may difficult the diagnosis of SARS-CoV-2 infections. To our knowledge, this is the first study to demonstrate, with a robust sample size (n = 7,370) and using highly specific and sensitive chemiluminescent microparticle immunoassay method, that covert SARS-CoV-2 infections are more frequent than previously expected in Dengue and Chikungunya hyperendemic regions. Moreover, our results suggest that SAR-CoV-2 cases were occurring prior to February, 2020, and that these undiagnosed missed cases may have contributed to the fast expansion of SARS-CoV-2 outbreak in Brazil. Data presented here demonstrate that in arboviral endemic regions, SARS-CoV-2 infection must be always considered, regardless of the existence of a previous positive diagnosis for Dengue or Chikungunya.Instituto de Higiene e Medicina Tropical (IHMT)Individual Health Care (IHC)Global Health and Tropical Medicine (GHTM)RUNStringari, Lorenzzo Lyriode Souza, Michel Norbimde Medeiros Junior, Nésio FernandesGoulart, Jaqueline PegorettiGiuberti, CamilaDietze, ReynaldoRibeiro-Rodrigues, Rodrigo2021-05-01T22:54:26Z2021-01-062021-01-06T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article21application/pdfhttp://hdl.handle.net/10362/116648eng1932-6203PURE: 27585349https://doi.org/10.1371/journal.pone.0244937info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-03-11T04:59:21Zoai:run.unl.pt:10362/116648Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:43:11.941139Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Covert cases of severe acute respiratory syndrome Coronavirus 2 an obscure but present danger in regions endemic for Dengue and Chikungunya viruses |
title |
Covert cases of severe acute respiratory syndrome Coronavirus 2 |
spellingShingle |
Covert cases of severe acute respiratory syndrome Coronavirus 2 Stringari, Lorenzzo Lyrio Adult Antibodies, Viral/blood Brazil/epidemiology COVID-19/complications Chikungunya Fever/epidemiology Chikungunya virus/pathogenicity Coinfection/epidemiology Dengue/epidemiology Dengue Virus/pathogenicity Diagnostic Errors/trends Disease Outbreaks Female Humans Immunoglobulin G/blood Male Middle Aged Prevalence SARS-CoV-2/pathogenicity Infectious Diseases SDG 3 - Good Health and Well-being |
title_short |
Covert cases of severe acute respiratory syndrome Coronavirus 2 |
title_full |
Covert cases of severe acute respiratory syndrome Coronavirus 2 |
title_fullStr |
Covert cases of severe acute respiratory syndrome Coronavirus 2 |
title_full_unstemmed |
Covert cases of severe acute respiratory syndrome Coronavirus 2 |
title_sort |
Covert cases of severe acute respiratory syndrome Coronavirus 2 |
author |
Stringari, Lorenzzo Lyrio |
author_facet |
Stringari, Lorenzzo Lyrio de Souza, Michel Norbim de Medeiros Junior, Nésio Fernandes Goulart, Jaqueline Pegoretti Giuberti, Camila Dietze, Reynaldo Ribeiro-Rodrigues, Rodrigo |
author_role |
author |
author2 |
de Souza, Michel Norbim de Medeiros Junior, Nésio Fernandes Goulart, Jaqueline Pegoretti Giuberti, Camila Dietze, Reynaldo Ribeiro-Rodrigues, Rodrigo |
author2_role |
author author author author author author |
dc.contributor.none.fl_str_mv |
Instituto de Higiene e Medicina Tropical (IHMT) Individual Health Care (IHC) Global Health and Tropical Medicine (GHTM) RUN |
dc.contributor.author.fl_str_mv |
Stringari, Lorenzzo Lyrio de Souza, Michel Norbim de Medeiros Junior, Nésio Fernandes Goulart, Jaqueline Pegoretti Giuberti, Camila Dietze, Reynaldo Ribeiro-Rodrigues, Rodrigo |
dc.subject.por.fl_str_mv |
Adult Antibodies, Viral/blood Brazil/epidemiology COVID-19/complications Chikungunya Fever/epidemiology Chikungunya virus/pathogenicity Coinfection/epidemiology Dengue/epidemiology Dengue Virus/pathogenicity Diagnostic Errors/trends Disease Outbreaks Female Humans Immunoglobulin G/blood Male Middle Aged Prevalence SARS-CoV-2/pathogenicity Infectious Diseases SDG 3 - Good Health and Well-being |
topic |
Adult Antibodies, Viral/blood Brazil/epidemiology COVID-19/complications Chikungunya Fever/epidemiology Chikungunya virus/pathogenicity Coinfection/epidemiology Dengue/epidemiology Dengue Virus/pathogenicity Diagnostic Errors/trends Disease Outbreaks Female Humans Immunoglobulin G/blood Male Middle Aged Prevalence SARS-CoV-2/pathogenicity Infectious Diseases SDG 3 - Good Health and Well-being |
description |
BACKGROUND: The impact of SARS-CoV-2 in regions endemic for both Dengue and Chikungunya is still not fully understood. Considering that symptoms/clinical features displayed during Dengue, Chikungunya and SARS-CoV-2 acute infections are similar, undiagnosed cases of SARS-CoV-2 in co-endemic areas may be more prevalent than expected. This study was conducted to assess the prevalence of covert cases of SARS-CoV-2 among samples from patients with clinical symptoms compatible with either Dengue or Chikungunya viral infection in the state of Espírito Santo, Brazil. METHODS: Presence of immunoglobulin G (IgG) antibody specific to SARS-CoV-2 nucleoprotein was detected using a chemiluminescent microparticle immunoassay in samples from 7,370 patients, without previous history of COVID-19 diagnosis, suspected of having either Dengue (n = 1,700) or Chikungunya (n = 7,349) from December 1st, 2019 to June 30th, 2020. FINDINGS: Covert cases of SARS-CoV-2 were detected in 210 (2.85%) out of the 7,370 serum samples tested. The earliest undiagnosed missed case of COVID-19 dated back to a sample collected on December 18, 2019, also positive for Dengue Virus. Cross-reactivity with either Dengue virus or other common coronaviruses were not observed. INTERPRETATION: Our findings demonstrate that concomitant Dengue or Chikungunya outbreaks may difficult the diagnosis of SARS-CoV-2 infections. To our knowledge, this is the first study to demonstrate, with a robust sample size (n = 7,370) and using highly specific and sensitive chemiluminescent microparticle immunoassay method, that covert SARS-CoV-2 infections are more frequent than previously expected in Dengue and Chikungunya hyperendemic regions. Moreover, our results suggest that SAR-CoV-2 cases were occurring prior to February, 2020, and that these undiagnosed missed cases may have contributed to the fast expansion of SARS-CoV-2 outbreak in Brazil. Data presented here demonstrate that in arboviral endemic regions, SARS-CoV-2 infection must be always considered, regardless of the existence of a previous positive diagnosis for Dengue or Chikungunya. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-05-01T22:54:26Z 2021-01-06 2021-01-06T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10362/116648 |
url |
http://hdl.handle.net/10362/116648 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
1932-6203 PURE: 27585349 https://doi.org/10.1371/journal.pone.0244937 |
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info:eu-repo/semantics/openAccess |
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openAccess |
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21 application/pdf |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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