JOIN USCo-infections: 19 patients affected with both Covid and Dengue so far in Karnataka
With frequent spells of rainfall in the past few days, one should watch out for co-infections of Covid and Dengue as 19 patients in Karnataka from six districts have gotten infected with both. Fortunately, there have been no deaths owing to co-infections so far and all the co-infected patients have recovered.
The six districts include Udupi, Gadag, Ballari, Dharwad, Kolar, and Dakshina Kannada. However, doctors have sounded caution as clinical treatments for Covid-19 and Dengue can be contradictory and hence very tricky for clinicians to prescribe and nurse patients back to health.
Both Covid-19 and Dengue share similarities in clinical signs and symptoms. Internal Medicine Consultant at Aster RV Hospital Dr SN Aravinda pointed out that both present with fever, body pain and headache. The differentiating factor is Dengue's rashes.
"The complication in Covid is blood clotting, whereas in Dengue, it is bleeding. Covid patients are treated with anticoagulants which are not to be used in treating Dengue," Dr Aravinda said.
About 30 per cent of the patients with Covid-19 pneumonia show blood clots. Patients will require anticoagulation with low molecular weight Heparin(LMWH). If the platelet counts fall below 100,000 or when there is evidence of active bleeding, LMWH needs to be discontinued immediately.
"Intravenous fluid therapy during co-infection depends on the hemodynamic status of the patient. It is quite a challenge managing Covid Acute Respiratory Distress Syndrome with guarded IV fluids when compared to aggressive fluid management for Dengue hemorrhagic fever. The use of ultrasound-guided fluid administration has become the mainstay of fluid management in ICUs which helps during Covid," Dr. Arjun Alva, HoD, Critical Care Department, Narayana Health City, told DH.
Dr Prashant Bhat, District Malaria Officer, Udupi, said, "Udupi district reported around eight or nine co-infections of Covid and Dengue. Fortunately, all have recovered. There were more cases reported in May and June. We had cyclonic rain in mid-May and this was one of the reasons for water stagnation (and breeding of mosquitoes)."
In Kolar district, the lone case of co-infection was reported in an entomologist (a person who studies insects). He was infected on May 12 and recovered on May 26.
District Surveillance Officer Dr Charini MA, said, "Surveillance for vector-borne diseases is very less since we are concentrating on Covid, this might be a reason for under detection of cases. In co-infections, complications include hampering of BT/CT (Bleeding Time/Clotting Time) and compromised renal functions. Luckily, he didn't have these."