Case Report: Extrapulmonary Manifestations of COVID-19 and Dengue Coinfection

Reyes-Ruiz, José Manuel; Campuzano-Vences, Rosa; Osuna-Ramos, Juan Fidel; De Jesús-González, Luis Adrián; Pérez-Méndez, María J.; González-González, Crescencio; Farfan-Morales, Carlos Noe; Rivas-Tovar, Leticia; Dávila-González, Eduardo; María del Ángel, Rosa; Gutiérrez-Garduño, Aarón P.; Villegas-del Ángel, Enrique; Zárate-Segura, Paola; Bastida-González, Fernando

The risk of coronavirus disease 2019 (COVID-19) and dengue coinfection is increased in tropical countries; however, the extrapulmonary clinical manifestations have not been fully characterized. We report a 42-year-old woman whose clinical manifestations began with fever, diarrhea, headache, chest pain, myalgia, odynophagia, and arthralgia. Despite mild respiratory symptoms and normal chest computed tomography scan results, she was diagnosed with real-time reverse-transcription polymerase chain reaction (RT-PCR)-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Because she had erythema and petechiae with a decreased platelet count, the dengue NS1 antigen and anti-dengue IgM/IgG test were performed, and the Centers for Disease Control and Prevention RT-PCR assay detected the dengue virus serotype 1 infection. Additionally, increased liver enzyme serum levels were found in the patient, who later developed hepatomegaly. Hence, the mechanism of hepatic pathology associated with SARS-CoV-2 and dengue coinfection needs further research.