COVID-19 and Dengue: Similarities and Differences

16 Aug 2021

Coronavirus disease (COVID-19) is an infectious disease mainly transmitted through droplets generated when an infected person coughs, sneezes, or exhales. Dengue, on the other hand, is a mosquito-borne viral infection. However, initial onset of both the diseases have overlapping symptoms. As both the diseases can be fatal in nature, it is crucial to understand the basic similarities and differences.

Both Dengue and COVID can present as mild diseases which subside itself and patients can recover at home. However, both COVID-19 and dengue can get severe resulting in a patient’s death.

Both the diseases are not age related. Anyone of any age can get infected by COVID-19 or dengue. Patients with various underlying chronic conditions such as heart diseases, kidney diseases or diabetes are at more risk for complications.

It is recommended that the patients seek clinical or hospital-based care at the onset of the symptoms as both the diseases may worsen before the test results arrive.

Dengue warning signs include persistent vomiting, mucosal bleeding, difficulty in breathing, bleeding from orifice, lethargy/restlessness and postural hypotension.

COVID-19 warning signs include difficulty in breathing, persistent headache, new confusion, inability to wake or stay awake, fall in oxygen levels and persistent high-grade fever beyond 7 days. This list doesn’t include all possible signa and symptoms. It may vary from patient to patient.

Dengue	COVID-19
Transmission
Dengue is caused by one of any of four related viruses: Dengue virus 1, 2, 3, and 4, transmitted to people through the bites of infected Aedes species mosquitoes	COVID-19, a respiratory illness caused by the virus SARS-CoV-2, is mainly transmitted when droplets containing the virus are inhaled or come into contact with the eyes, nose, or mouth
Incubation Period
The incubation period for dengue ranges between 3-10 days, typically 5-7 days.	The incubation period for COVID-19 may extend to 14 days, with a median of 4-5 days from exposure to symptoms onset.

Signs and Symptoms

Mild to moderate disease

Febrile phase (0-7 days)

Fever

Headache with eye pain

Nausea

Vomiting

Rash

Leukopenia

Warning signs for severe illness: abdominal pain or tenderness, persistent vomiting, clinical fluid accumulation, mucosal bleeding, lethargy, restlessness, and liver enlargement.

Critical Phase

Warning signs may appear, and rapid clinical deterioration may occur within 48 hours after defervescence (3–7 days after fever onset).

Mild to moderate disease

Fever or chills

Cough

Shortness of breath or difficulty breathing

Fatigue

Muscle or body aches

Headache

New loss of taste or smell

Sore throat

Congestion or runny nose

Nausea or vomiting

Diarrhea

NOTE: This is not an inclusive list.

Severe Illness

Severe dengue is defined by dengue with any of the following symptoms and signs:

Plasma leakage leading to shock

Fluid accumulation with respiratory distress

Severe bleeding with thrombocytopenia

Severe organ impairment such as liver disease

Cardiac impairment

Signs and symptoms for severe illness can include:

dyspnea

hypoxia

respiratory failure

shock

multiorgan system dysfunction

Clinicians should be aware of the potential for some patients to rapidly deteriorate one week after illness onset.

Risk Factors for Severe Illness

Risk factors for severe dengue include:

Age (infant)

Patients with chronic medical conditions, including diabetes, asthma, or heart disease

Risks factors for severe illness with COVID-19 include:

Age >65

Underlying conditions like cardiovascular disease, diabetes, chronic respiratory disease, hypertension, prior stroke, liver disease, obesity, chronic lung disease, chronic kidney disease undergoing dialysis.

Dr. Sushila Kataria Senior Director