Effects of recent prior dengue infection on risk and severity of subsequent SARS-CoV-2 infection: a retrospective cohort study

Background and Aims. Elucidating whether prior dengue potentially confers cross-protection against COVID-19 is of public health importance in tropical countries at risk of overlapping dengue and COVID-19 epidemics. However, studies to date have yielded conflicting results. We aimed to assess effects...

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Main Authors: Tang, Nicole, Lim, Jue Tao, Dickens, Borame, Chiew, Calvin, Ng, Lee Ching, Chia, Po Ying, Leo, Yee Sin, Lye, David C., Tan, Kelvin Bryan, Wee, Liang En
Other Authors: Lee Kong Chian School of Medicine (LKCMedicine)
Format: Article
Language:English
Published: 2024
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Online Access:https://hdl.handle.net/10356/181553
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spelling sg-ntu-dr.10356-1815532024-12-15T15:38:57Z Effects of recent prior dengue infection on risk and severity of subsequent SARS-CoV-2 infection: a retrospective cohort study Tang, Nicole Lim, Jue Tao Dickens, Borame Chiew, Calvin Ng, Lee Ching Chia, Po Ying Leo, Yee Sin Lye, David C. Tan, Kelvin Bryan Wee, Liang En Lee Kong Chian School of Medicine (LKCMedicine) National Centre for Infectious Diseases, Singapore Ministry of Health, Singapore Tan Tock Seng Hospital Yong Loo Lin School of Medicine, NUS Saw Swee Hock School of Public Health, NUS Duke-NUS Graduate Medical School Medicine, Health and Life Sciences COVID-19 Dengue Background and Aims. Elucidating whether prior dengue potentially confers cross-protection against COVID-19 is of public health importance in tropical countries at risk of overlapping dengue and COVID-19 epidemics. However, studies to date have yielded conflicting results. We aimed to assess effects of recent prior dengue infection on risk and severity of subsequent SARSCoV-2 infection among adult Singaporeans. Methods. A retrospective cohort study including all adult Singaporeans aged ≥18 years was conducted from 1 July 2021 through 31 October 2022, when a dengue outbreak driven by the DENV3 serotype preceded subsequent waves of SARS-CoV-2 Delta/Omicron transmission in Singapore. SARS-CoV-2 and dengue infection status were classified using national registries. Cox regression models adjusted for demographics, COVID-19 vaccination status, comorbidity, and socioeconomic-status were used to assess risks and severity (hospitalization, severe illness) of SARS-CoV-2 infection occurring after previous recorded dengue infection. Results. A total of 3 366 399 individuals were included, contributing 1 399 696 530 person-days of observation. A total of 13 434 dengue infections and 1 253 520 subsequent SARS-CoV-2 infections were recorded; with an average of 94.7 days (standard deviation = 83.8) between dengue infection and SARS-CoV-2 infection. Preceding dengue infection was associated with a modest increase in risk of subsequent SARS-CoV-2 infection (adjusted hazards ratio [aHR] = 1.13; 95% confidence interval [CI], 1.08–1.17), and significantly elevated risk of subsequent COVID-19 hospitalization (aHR = 3.25; 95% CI, 2.78–3.82) and severe COVID-19 (aHR = 3.39; 95% CI, 2.29–5.03). Conclusions. Increased risk of SARS-CoV-2 infection and adverse COVID-19 outcomes were observed following preceding dengue infection in a national population-based cohort of adult Singaporeans. This observation is of significance in tropical countries with overlapping dengue and COVID-19 outbreaks. Ministry of Education (MOE) Published version This work was not grant-funded. L. E. W. is supported by the Singhealth Regional Health Systems PULSES Fellowship. J. T. L. is supported by the Ministry of Education (MOE), Singapore Start-up Grant. 2024-12-09T06:18:33Z 2024-12-09T06:18:33Z 2024 Journal Article Tang, N., Lim, J. T., Dickens, B., Chiew, C., Ng, L. C., Chia, P. Y., Leo, Y. S., Lye, D. C., Tan, K. B. & Wee, L. E. (2024). Effects of recent prior dengue infection on risk and severity of subsequent SARS-CoV-2 infection: a retrospective cohort study. Open Forum Infectious Diseases, 11(8), ofae397-. https://dx.doi.org/10.1093/ofid/ofae397 2328-8957 https://hdl.handle.net/10356/181553 10.1093/ofid/ofae397 39091642 2-s2.0-85200898167 8 11 ofae397 en MOE SUG Open Forum Infectious Diseases © The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. application/pdf
institution Nanyang Technological University
building NTU Library
continent Asia
country Singapore
Singapore
content_provider NTU Library
collection DR-NTU
language English
topic Medicine, Health and Life Sciences
COVID-19
Dengue
spellingShingle Medicine, Health and Life Sciences
COVID-19
Dengue
Tang, Nicole
Lim, Jue Tao
Dickens, Borame
Chiew, Calvin
Ng, Lee Ching
Chia, Po Ying
Leo, Yee Sin
Lye, David C.
Tan, Kelvin Bryan
Wee, Liang En
Effects of recent prior dengue infection on risk and severity of subsequent SARS-CoV-2 infection: a retrospective cohort study
description Background and Aims. Elucidating whether prior dengue potentially confers cross-protection against COVID-19 is of public health importance in tropical countries at risk of overlapping dengue and COVID-19 epidemics. However, studies to date have yielded conflicting results. We aimed to assess effects of recent prior dengue infection on risk and severity of subsequent SARSCoV-2 infection among adult Singaporeans. Methods. A retrospective cohort study including all adult Singaporeans aged ≥18 years was conducted from 1 July 2021 through 31 October 2022, when a dengue outbreak driven by the DENV3 serotype preceded subsequent waves of SARS-CoV-2 Delta/Omicron transmission in Singapore. SARS-CoV-2 and dengue infection status were classified using national registries. Cox regression models adjusted for demographics, COVID-19 vaccination status, comorbidity, and socioeconomic-status were used to assess risks and severity (hospitalization, severe illness) of SARS-CoV-2 infection occurring after previous recorded dengue infection. Results. A total of 3 366 399 individuals were included, contributing 1 399 696 530 person-days of observation. A total of 13 434 dengue infections and 1 253 520 subsequent SARS-CoV-2 infections were recorded; with an average of 94.7 days (standard deviation = 83.8) between dengue infection and SARS-CoV-2 infection. Preceding dengue infection was associated with a modest increase in risk of subsequent SARS-CoV-2 infection (adjusted hazards ratio [aHR] = 1.13; 95% confidence interval [CI], 1.08–1.17), and significantly elevated risk of subsequent COVID-19 hospitalization (aHR = 3.25; 95% CI, 2.78–3.82) and severe COVID-19 (aHR = 3.39; 95% CI, 2.29–5.03). Conclusions. Increased risk of SARS-CoV-2 infection and adverse COVID-19 outcomes were observed following preceding dengue infection in a national population-based cohort of adult Singaporeans. This observation is of significance in tropical countries with overlapping dengue and COVID-19 outbreaks.
author2 Lee Kong Chian School of Medicine (LKCMedicine)
author_facet Lee Kong Chian School of Medicine (LKCMedicine)
Tang, Nicole
Lim, Jue Tao
Dickens, Borame
Chiew, Calvin
Ng, Lee Ching
Chia, Po Ying
Leo, Yee Sin
Lye, David C.
Tan, Kelvin Bryan
Wee, Liang En
format Article
author Tang, Nicole
Lim, Jue Tao
Dickens, Borame
Chiew, Calvin
Ng, Lee Ching
Chia, Po Ying
Leo, Yee Sin
Lye, David C.
Tan, Kelvin Bryan
Wee, Liang En
author_sort Tang, Nicole
title Effects of recent prior dengue infection on risk and severity of subsequent SARS-CoV-2 infection: a retrospective cohort study
title_short Effects of recent prior dengue infection on risk and severity of subsequent SARS-CoV-2 infection: a retrospective cohort study
title_full Effects of recent prior dengue infection on risk and severity of subsequent SARS-CoV-2 infection: a retrospective cohort study
title_fullStr Effects of recent prior dengue infection on risk and severity of subsequent SARS-CoV-2 infection: a retrospective cohort study
title_full_unstemmed Effects of recent prior dengue infection on risk and severity of subsequent SARS-CoV-2 infection: a retrospective cohort study
title_sort effects of recent prior dengue infection on risk and severity of subsequent sars-cov-2 infection: a retrospective cohort study
publishDate 2024
url https://hdl.handle.net/10356/181553
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