MANAGEMENT OF CO-INFECTION OF COVID-19 WITH OTHER SEASONAL EPIDEMIC PRONE DISEASES

Almost all States/UTs of the country are affected by COVID-19. Given the seasonal pattern of epidemic-prone diseases observed every year in our country, it diseases like Dengue, Malaria, Seasonal Influenza, Leptospirosis, Chikungunya, Enteric fever, etc. can not only present as a diagnostic dilemma but may co-exist in COVID cases.

This poses challenges in clinical and laboratory diagnosis of COVID, and have a bearing on clinical management and patient outcomes.

SCOPE

The scope of this document is to provide clear guidelines on prevention and treatment of co-infections of COVID with diseases like Dengue, Malaria, Seasonal Influenza (H1N1), Leptospirosis, Chikungunya etc.

CLINICAL FEATURES

As per the World Health Organization (WHO) case definition, a COVID case may present with:

• Acute onset of fever AND cough; OR

• Acute onset of ANY THREE OR MORE of the following signs or symptoms: fever, cough, general weakness/ fatigue, headache, myalgia, sore throat, coryza, dyspnoea, anorexia/ nausea/ vomiting, diarrhoea, altered mental status.

This case definition, although sensitive, is not very specific. Seasonal epidemic-prone diseases, as cited in the foregoing paragraphs may all present as febrile illness, with symptoms that mimic COVID-19. If there is a coinfection, then apart from the febrile illness there may be constellation of signs and symptoms that may lead to difficulty in diagnosis. A comparative analysis of disease onset, symptoms, signs, warning signs, complications and diagnosis is given at Annexure.

APPROACH TO DIAGNOSIS OF SUSPECTED CO-INFECTION