Clinical manifestations and laboratory findings in patients coinfected with dengue virus and SARS-CoV-2: a systematic review.

Clinical manifestations and laboratory findings in patients coinfected with dengue virus and SARS-CoV-2: a systematic review.

Publication date: Jun 12, 2026

Dengue Hemorrhagic Fever and Coronavirus disease 2019 (COVID-19) are infectious diseases caused by dengue virus (DENV) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). While DENV remains endemic in many tropical regions, SARS-CoV-2 spread globally beginning in 2020. Reports of coinfection have emerged from several countries. This systematic review describes the clinical manifestations and laboratory findings reported in patients coinfected with DENV and SARS-CoV-2. This review followed the PRISMA guidelines and collecting data from PubMed for articles published between 2020 and 2025 that discussed DENV and SARS-CoV-2 coinfection. Eligible study designs included theoretical articles, case reports, case series, and cohort studies. Data were synthesized descriptively due to heterogeneity and the absence of comparator groups. Fifteen studies met the inclusion criteria, identifying 65 patients with SARS-CoV-2 and DENV coinfection. Reported symptoms included fever (69%), vomiting (57%), abdominal pain (55%), rash (54%), and shock (51%). Laboratory findings also showed hematological and physiological alterations including hypotension (57. 14%), tachypnea (50%), fever (62. 5%), neutropenia (33. 33%), neutrophilia (50%), lymphopenia (42. 86%), and lymphocytosis (28. 57%). These percentages represent descriptive counts across heterogeneous case reports and do not reflect prevalence estimates. Patients with DENV and SARS-CoV-2 coinfection exhibit a range of clinical and laboratory abnormalities, but the available evidence-primarily case reports and case series without comparator groups-does not allow conclusions about disease severity or prognosis relative to monoinfection. The findings should therefore be interpreted as descriptive and hypothesis-generating. Careful diagnostic evaluation and clinical monitoring remain essential in suspected coinfection cases. Not applicable.

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Concepts Keywords
Coronavirus Coinfection
Dengue COVID-19
Laboratory Dengue
Lymphocytosis Immunological homeostasis
Systematic

Semantics

Type Source Name
disease MESH dengue
disease MESH Dengue Hemorrhagic Fever
disease MESH Coronavirus disease 2019
disease MESH infectious diseases
disease MESH severe acute respiratory syndrome
disease MESH coinfection
disease MESH included
drug DRUGBANK Methionine
disease MESH fever
disease MESH vomiting
disease MESH abdominal pain
disease MESH rash
disease MESH shock
disease MESH hypotension
disease MESH tachypnea
disease MESH neutropenia
disease MESH lymphopenia
disease MESH lymphocytosis
disease MESH Dis
pathway REACTOME Reproduction
disease MESH arthralgias
disease MESH infection
disease MESH sore throat
disease MESH anosmia
disease MESH altered taste
disease MESH headache
disease MESH nausea
disease MESH myalgia
disease MESH lethargy
disease MESH diarrhea
drug DRUGBANK Oxygen
drug DRUGBANK Pentaerythritol tetranitrate
disease MESH inflammation
disease MESH autoimmune diseases
disease MESH cancers
disease MESH injury
disease MESH Viral infections
disease MESH hepatitis
disease MESH rubella
disease MESH measles
pathway KEGG Measles
disease MESH chicken pox
disease MESH influenza
disease MESH parainfluenza
disease MESH leukocyte adhesion deficiency
disease MESH syndromes
disease MESH chronic granulomatous disease
disease MESH Shwachman Diamond syndrome
disease MESH Chediak Higashi syndrome
disease MESH mumps
disease MESH aches
disease MESH muscle cramp
drug DRUGBANK Favipiravir
drug DRUGBANK Hydroxychloroquine
disease MESH asthenia
disease MESH cough
disease MESH petechiae
disease MESH chills
disease MESH pulmonary edema
disease MESH hepatomegaly
disease MESH Fatigue
disease MESH rhinorrhea
disease MESH paresthesia
disease MESH paraparesis
disease MESH chest pain
disease MESH itching
disease MESH low back pain
disease MESH hyperemia
disease MESH edema
drug DRUGBANK Albendazole
disease MESH Park
disease MESH Metabolic Diseases

Original Article

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