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COVID-19, Dengue Double Infection Treatment Complicated; Needs Balanced Approach: Experts

According to Medical Director of Rajiv Gandhi Super Speciality Hospital, both Dengue and COVID-19 have no specific treatment, which makes it even difficult for treating doctors of patients with both diseases

COVID-19, Dengue Double Infection Treatment Complicated; Needs Balanced Approach: Experts
Highlights
  • Take preventive measures to avoid Dengue and COVID-19: Experts
  • Malaria, dengue have overlapping symptoms with COVID-19: Doctor
  • A “finely balanced” approach is needed to tackle both diseases: Doctor

New Delhi: There is “no standard protocol” for treatment of patients who have contracted a double infection of COVID-19 and dengue, and a very “finely balanced” approach is needed to tackle both the ailments at once, experts said. Delhi Deputy Chief Minister Manish Sisodia was shifted to LNJP Hospital on Wednesday for COVID-19 treatment and tested positive for dengue a day later. On Thursday evening, the 48-year-old AAP leader was shifted to the ICU of Max Hospital Saket here. He had tested positive for COVID-19 on September 14 and is perhaps the first prominent personality in the city to have been diagnosed with both infections.

Also Read: Anaemia May Contribute To The Spread Of Dengue, Suggests Study

Medical Director of Rajiv Gandhi Super Speciality Hospital (RGSSH) B L Sherwal said both the diseases have no specific treatment, which makes it even difficult for treating doctors of such patients.

Both COVID-19 and dengue need symptomatic treatment and in some aspects the treatment is kind of contradictory and thus tricky. In COVID-19, we inject heparin drug subcutaneously which ultimately reaches the blood stream, and this is done to prevent embolism in these patients which can prove fatal, he told PTI .

Embolism is sudden blocking of an artery which can obstruct flow of oxygen, and that is why some patients get complications even after treatment, the doctor said. RGSSH is a dedicated COVID-19 facility run by the Delhi government.

In dengue, on the other hand, platelets infusion is needed in cases where its count has fallen to dangerously low level. So, it’s kind of opposite. And, therefore, we can’t inject heparin if a COVID-19 patient has dengue too, Dr. Sherwal said.

So, for a treating doctor it is like “walking a tight rope” and a very “finely balanced approach” is needed, he said. Vikas Maurya, Director and Head of Department, Pulmonology, Fortis Hospital Shalimar Bagh, also feels a balanced approach is needed in tackling the “double infection” of COVID-19 and dengue.

One will have to also see which disease takes preponderance in such a patient, and the course of treatment will depend accordingly. Both are spread by virus, so it is quite an unusual scenario for a doctor as well as the patient, he said on Friday.

Also Read: Delhi Chief Minister Announces ‘Pusa Decomposer’ For Speedy Decomposition Of Stubble

Dr. Maurya also referred to a “study done by a university in Brazil along with an American varsity”.

Though the study is yet to be peer-reviewed, one of its findings was that in patients who had suffered dengue infection earlier had developed anti-bodies, and in some patients, a false positive result was coming for COVID-19, even with RT-PCR test. But it is too early to say anything, he added.

Rajesh Rautela, Medical Superintendent of GTB Hospital, said a doctor “will have to be like a juggler, balancing two things at the same time”.

So, the best way is to take precautions and preventive measures to avoid stagnation of water where mosquitoes can breed. No medicinal cure is there for either of the two ailments, just symptomatic treatment, so people should be alert, he said.

Mugdha Tapdiya, senior consultant, internal medicine at Fortis Hospital, Vasant Kunj said,

Diseases like malaria and dengue have overlapping symptoms with COVID-19, except where there are respiratory symptoms. If there is a co-infection with dengue in which there is a risk of hemorrhage, then management becomes very tricky. Similarly there is a capillary leak in dengue fever which is treated by intravenous fluids, whereas with co-infection of COVID-19, large intravenous fluid is a risk in the view of potential trial risk of ARDS and pulmonary oedema.

Sources at LNJP Hospital on Thursday said “there is no standard protocol” for treatment of double infection of COVID-19 and dengue, and treatment is “patient-specific”. LNJP Hospital is the largest hospital under the Delhi government and a dedicated COVID-19 facility.

Also Read: Second Wave Of COVID-19 Hits Its Peak In Delhi, Number Of Cases To Decline In Coming Days: Chief Minister Kejriwal

The patient’s age, condition, comorbidities and other factors are taken into account for treatment of both the ailments, a source said.

Asked if there are any side effects of treatments in cases of a “double infection”, the source said,

Any treatment can have a side effect, but the treating doctor decides the methodology for it.

A dengue patient, if his or her platelets level falls dangerously below the normal level, needs external platelets infusion. A normal platelets level is considered in the range of 1.5-4.5 lakh, according to doctors.

If a patient needs plasma for COVID-19 treatment, he can be administered that, and if he needs platelets that too can be infused. The treating doctor will decide the course of treatment, the source said.

Common symptoms of COVID-19 are high fever, breathlessness, cough, body fatigue and loss of sense of smell and taste. In dengue, a vector-born disease caused by aedes aegypti mosquito, a person runs high fever, suffers red rashes on skin, pain behind eye sockets, joint pain and in serious case internal bleeding which can prove fatal.

In about 10 per cent of dengue cases, a patient suffers haemorrhagic fever which leads to deaths. Internal bleeding can manifest through nose, gums and those are danger signs, Dr. Sherwal said.

Recently, Delhi Health Minister Satyendar Jain, himself a COVID-19 survivor, had told reporters that about 2-3 patients of COVID-19 in Delhi had shown dengue infection too.

We have managed to contain dengue this year. Our campaign ’10 Hafte 10 Baje 10 Minute’ was very effective last year, and this year too dengue situation in Delhi is under control, he had said.

Also Read: COVID-19: With Safety Measures In Place, Gyms Re-Open In Delhi

(Except for the headline, this story has not been edited by NDTV staff and is published from a syndicated feed.)

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World

26,27,61,966Cases
22,35,18,265Active
3,40,28,506Recovered
52,15,195Deaths
Coronavirus has spread to 196 countries. The total confirmed cases worldwide are 26,27,61,966 and 52,15,195 have died; 22,35,18,265 are active cases and 3,40,28,506 have recovered as on December 1, 2021 at 3:56 am.

India

3,45,96,776 8,954Cases
99,0231,520Active
3,40,28,506 10,207Recovered
4,69,247 267Deaths
In India, there are 3,45,96,776 confirmed cases including 4,69,247 deaths. The number of active cases is 99,023 and 3,40,28,506 have recovered as on December 1, 2021 at 2:30 am.

State Details

State Cases Active Recovered Deaths
Maharashtra

66,35,658 678

11,226 299

64,83,435 942

1,40,997 35

Kerala

51,41,814 4,723

44,314 824

50,57,368 5,370

40,132 177

Karnataka

29,96,148 291

6,445 462

29,51,492 745

38,211 8

Tamil Nadu

27,26,917 720

8,244 47

26,82,192 758

36,481 9

Andhra Pradesh

20,72,909 184

2,149 47

20,56,318 134

14,442 3

Uttar Pradesh

17,10,399 12

89 3

16,87,399 8

22,911 1

West Bengal

16,16,083 705

7,731 2

15,88,866 694

19,486 13

Delhi

14,40,934 34

287 2

14,15,549 32

25,098

Odisha

10,49,108 228

2,188 23

10,38,509 203

8,411 2

Chhattisgarh

10,06,813 34

318 0

9,92,902 34

13,593

Rajasthan

9,54,785 15

193 6

9,45,637 9

8,955

Gujarat

8,27,475 40

275 13

8,17,108 27

10,092

Madhya Pradesh

7,93,170 20

119 7

7,82,523 27

10,528

Haryana

7,71,709 17

163 2

7,61,492 19

10,054

Bihar

7,26,223 4

36 3

7,16,524 7

9,663

Telangana

6,75,994 196

3,591 10

6,68,411 184

3,992 2

Assam

6,16,852 144

2,625 30

6,08,124 109

6,103 5

Punjab

6,03,279 21

325 4

5,86,352 22

16,602 3

Jharkhand

3,49,244 12

98 3

3,44,006 9

5,140

Uttarakhand

3,44,255 28

141 9

3,36,706 19

7,408

Jammu And Kashmir

3,36,852 171

1,625 1

3,30,751 172

4,476

Himachal Pradesh

2,27,195 102

834 10

2,22,513 91

3,848 1

Goa

1,78,928 38

284 8

1,75,260 30

3,384

Mizoram

1,35,175 365

3,751 54

1,30,927 415

497 4

Puducherry

1,28,924 31

284 12

1,26,768 43

1,872

Manipur

1,25,205 36

649 6

1,22,579 40

1,977 2

Tripura

84,805 14

81 3

83,900 10

824 1

Meghalaya

84,480 19

294 9

82,713 9

1,473 1

Chandigarh

65,465 9

65 7

64,580 2

820

Arunachal Pradesh

55,276 3

35 0

54,961 3

280

Sikkim

32,242 9

124 3

31,715 6

403

Nagaland

32,122 13

133 7

31,293 20

696

Ladakh

21,578 38

276 26

21,088 12

214

Dadra And Nagar Haveli

10,683

1 0

10,678

4

Lakshadweep

10,394

24 0

10,319

51

Andaman And Nicobar Islands

7,683

6 2

7,548 2

129

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