Risks of Acute Cholecystitis, Acute Pancreatitis, and Acute Appendicitis in Patients with Dengue Fever: A Population-Based Cohort Study in Taiwan

Long-term Sequelae Following Dengue Infection vs SARS-CoV-2 Infection in a Pediatric Population: A Retrospective Cohort Study

Background

Long-term postacute sequelae following SARS-CoV-2 infection in children have been extensively documented. However, while persistence of chronic symptoms following pediatric dengue infection has been documented in small prospective cohorts, population-based studies are limited. We evaluated the risk of multisystemic complications following dengue infection in contrast to that after SARS-CoV-2 infection in a multiethnic pediatric Asian population.

Methods

This retrospective population-based cohort study utilized national COVID-19/dengue registries to construct cohorts of Singaporean children aged 1 to 17 years with either laboratory-confirmed dengue infection from 1 January 2017 to 31 October 2022 or confirmed SARS-CoV-2 infection from 1 July 2021 to 31 October 2022. Cox regression was utilized to estimate risks of new-incident cardiovascular, neurologic, gastrointestinal, autoimmune, and respiratory complications, as identified by national health care claims data, at 31 to 300 days after dengue infection vs COVID-19. Risks were reported by 2 measures: adjusted hazard ratio (aHR) and excess burden.

Results

This study included 6452 children infected with dengue and 260 749 cases of COVID-19. Among children infected with dengue, there was increased risk of any postacute gastrointestinal sequelae (aHR, 2.98; 95% CI, 1.18-7.18), specifically appendicitis (aHR, 3.50; 95% CI, 1.36-8.99), when compared with children infected with SARS-CoV-2. In contrast to cases of unvaccinated COVID-19, children infected with dengue demonstrated lower risk (aHR, 0.42; 95% CI, .29-.61) and excess burden (-6.50; 95% CI, -9.80 to -3.20) of any sequelae, as well as lower risk of respiratory sequelae (aHR, 0.17; 95% CI, .09-.31).

Conclusions

Lower overall risk of postacute complications was observed in children following dengue infection vs COVID-19; however, higher risk of appendicitis was reported 31 to 300 days after dengue infection vs SARS-CoV-2. Public health strategies to mitigate the impact of dengue and COVID-19 in children should consider the possibility of chronic postinfectious sequelae.

Dengue fever presenting with acute pancreatitis: A case report

Acute pancreatitis is an acute inflammation of the pancreas, with subsequent involvement of surrounding tissues and organ systems. Viral etiology of acute pancreatitis is uncommon; however, multiple viruses have been implicated. Dengue virus has also been found responsible for acute pancreatitis, with possible etiologies linked to direct viral invasion, autoimmune mechanism, or as a complication of dengue shock syndrome. We present a case of a 24-year-old female who presented with epigastric pain and vomiting in the background of a febrile illness and was later diagnosed with mild acute pancreatitis complicating dengue fever.

The role of the radiologist in the dengue endemic: a pictorial essay

The dengue virus, a member of the family Flaviviridae, is transmitted by Aedes mosquitoes and causes a viral disease known as dengue fever that is prevalent in tropical and subtropical regions. It is estimated that there are 100-400 million new infections every year, with underreporting due to limited surveillance systems. The presentation ranges from asymptomatic to dengue shock syndrome. Brazil is now facing an endemic of dengue, having seen a significant seasonal increase of over 4.5 million in the number of probable cases reported. Imaging exams such as ultrasound, computed tomography, and magnetic resonance imaging are crucial for detecting complications of dengue, aiding in the clinical management and differential diagnosis, especially in severe cases. The aim of this study was to illustrate the radiological findings of dengue, focusing on emergency and critical care settings.