Dados do Trabalho

Título

Dengue in the post-COVID-19 era: evaluation of vascular leakage and coagulopathy biomarkers.

Introdução

The COVID-19 pandemic caused by the SARS-CoV-2 virus has resulted in global challenges due to high mortality and morbidity and the risk of interaction with other diseases, such as Dengue. The pathogenesis of COVID-19 and Dengue are similar. Both diseases involve vascular endothelium, which is critical in inflammation and a target of cytokine dysregulation. This is seen in acute respiratory distress syndrome in COVID-19, coagulopathy, and vascular extravasation in Dengue. A computational docking study observed antigenic similarities between SARS-CoV-2 and DENV and discovered that human antibodies against DENV can bind to the Spike domain of SARS-CoV-2. Thus, prior exposure to DENV may provide some cross-protection against SARS-CoV-2.

Objetivo (s)

To evaluate whether the levels of Syndecan-1 (SDC-1), Tissue Factor (TF), and Tissue Factor Inhibitor (TFPI), related to vascular and coagulation changes, respectively, are different between Dengue patients before and after COVID-19.

Material e Métodos

76 serum/plasma samples were recruited from pre- (n=16, 2018 epidemic) and post-COVID-19 Dengue (n=50, 2023) patients and healthy post-COVID-19 individuals (n=10, 2024). We used DENV IgM and IgG kits (Euroimmun) and Platelia NS1 Ag ELISA (BioRad) for diagnosis. An anti-SARS-CoV-2 S1 IgG kit (Euroimmun) was used to verify exposure to SARS-CoV2. The SDC-1, TF, and TFPI levels were measured by ELISAs (R&D Systems). The Kruskal-Wallis and Chi-square tests (GraphPad PRISM) were performed for statistical analysis. P<0.05 was considered significant.

Resultados e Conclusão

We highlight that patients with post-COVID-19 Dengue are younger and have more days of illness; have less arthralgia/myalgia and more retro-orbital pain and rash than pre-COVID-19 Dengue. No differences were seen in anti-DENV IgG detection in the three groups. Most patients with post-COVID-19 Dengue have anti-SARS-CoV2 IgA and IgG. Increased levels of SDC-1 were observed post-COVID-19 compared to healthy individuals. The analysis of high producers of SDC-1 showed that 85% are post-COVID-19 and 40% are pre-COVID-19. Similar TF levels were found in all three groups. High levels of TFPI were shown post-COVID-19 than pre-COVID-19. A trend towards a lower TF/TFPI ratio was observed post-COVID-19 compared to pre-COVID-19. Conclusion: Our preliminary data suggests that there could be a higher risk of endothelial dysfunction in post-COVID-19 Dengue, but better control of hypercoagulability compared to pre-COVID-19 Dengue. 

Palavras Chave

TFPI; SINDECAN-1; DENV; COVID-19; coagulopathy; vascular extravasation