Covid or Dengue: How to identify overlapping symptoms?

Many dengue patients are showing symptoms that are identical to Covid-19 as dengue cases increase around the national capital, leaving both patients and doctors perplexed about the exact diagnosis.

Cases of vector-borne diseases are usually reported between July and November, sometimes stretching till mid-December.

Its symptoms include high fever, headache, rash and muscle and joint pain, which are quite similar to that of COVID-19 which also includes fever or chills, muscle or body aches, fatigue and headache among others.

In such a situation it has become difficult to ascertain whether a person suffering from fever, body ache and headache is Covid positive or not, doctors said.

"Covid cases are declining right now, but the virus is still there. I am still seeing Covid cases in my OPD. In the last 3-4 days, two cases were detected in OPD and one later in an ICU. However, on an average, dengue infection is on rise right now," said Dr Suranjit Chatterjee, a senior consultant at Apollo Hospitals.

"There are a few overlapping symptoms when it comes to both dengue and Covid, such as fever, bodyache and headache, and in such cases diagnosis cannot be that black and white. So, we are prescribing both Covid and dengue test to ascertain the exact infection. In fact, in some cases, even malaria and typhoid tests are also being done," he said.

However, if a patient is suffering more from sore throat and cough and their fever is not very high, then Covid infection is more probable. So, a dengue test is not being prescribed in cases "where we can differentiate from the nature of symptoms," Chatterjee added.

Doctors at many government and private hospitals are reporting a rise in footfall in OPDs after a continuous spike in dengue cases in Delhi in the past two weeks. Most of the patients are complaining of fever, cough, sore throat and body ache or headache or both.

Lok Nayak Jai Prakash (LNJP) Hospital - Delhi government's largest hospital and the main COVID-19 facility - is also reporting dengue cases with some of the patients being admitted after their platelets level had fallen beyond the normal range.

Dengue fever can result in a drop in white blood cell and platelet counts. The normal platelet count in the body ranges from 1.5 to 4 lacs, which can go down to as low as 20,000 to 40,000 in the case of dengue patients.

"Yes, rising dengue cases are making diagnosis difficult now. Earlier, we would analyse symptoms and Covid test would be prescribed if they had fever or other matching symptoms. Now not only patients, but even doctors are confused about the exact ailment due to their overlapping symptoms," a senior doctor at the hospital said.
Over 520 dengue cases have been reported in Delhi this year till September 21, as per the data shared by the Municipal Corporation of Delhi (MCD).

According to a report released by the civic body on September 26, as many as 281 cases have been reported this month alone till September 21.

The spurt in dengue cases in the national capital has come after Delhi was lashed by incessant rains recently.
106 cases of malaria and 20 cases of chikungunya have also been reported this year in Delhi in the same period, the report said.

Of the 525 total cases recorded till September 21 this year, 75 were reported in August, which is the highest number of dengue cases logged between January 1 to September 21 since 2017, when the corresponding figure was 1,807.

Malaria, dengue and chikungunya are accompanied by high-grade fever and, therefore, doctors feel that people might think that they have contracted COVID-19, or even vice-versa.

Chatterjee said many people are reluctant to get the COVID-19 test done, fearing they will have to go in isolation as they want to "go on with their lives".

"So, given the slump in daily Covid cases in Delhi and rise in dengue cases, many are assuming that if they have fever or sore throat or body ache, it is either regular viral infection or something else, but not Covid. But, it could be Covid too, as the coronavirus is still amidst us," he cautioned and urged people to get themselves tested for Covid too if symptoms persist.

At many workplaces, employees continue to work despite having cough, cold or sore throat, while earlier when the COVID-19 cases were on the rise, it would have been a strict no-no with an option of a 'work from home' regimen given to them, doctors said.

"But, I would urge people to not assume any kind of fever as a regular flu, if their symptoms are prolonged and intense, consult a doctor," Chatterjee added.

(WIth inputs from PTI)