Navigating the Nexus: A Comprehensive Review of Dengue and COVID-19 Co-infection from Pathogenesis to Public Health Strategy

Abstract

Dengue virus (DENV) and SARS-CoV-2 co-exist in tropical and subtropical areas, which constitute
a global health challenge of high importance and evolution. This review paper is a synthesis of the
current evidence on the complex relationship between these two pathogens, including the
pathogenesis and transmission dynamics of each, as well as their integrated effects on public health.
We will initially examine the complicated immunological interactions, such as serological cross-
reactivity, which make diagnosis complex and may determine the disease severity. This review
subsequently examines the diagnostic issues that are caused by these overlapping clinical and
laboratory abnormalities, which tend to result in misclassification and delayed treatment, and the
development of multiplex molecular diagnostics. We evaluate the epidemiological data based on
reported co-infection cases and analyse them in terms of geographic and demographic distribution
and related prognostic factors. Moreover, the article discusses comparative trends, such as the
disruptive nature of the COVID-19 pandemic on the regular dengue monitoring and management of
vectors and focuses on the different approaches toward managing this disease and the pharmacological
interventions. We also present the contribution of mathematical modelling in co-infection dynamics
prediction and the complicated RNA dynamics of co-infected patients. The review then summarizes
the findings by determining the major gaps in the literature on the real burden of the disease,
pathophysiology, and optimal management of this dual infectious menace. It underlines the pressing
need to possess combined surveillance, coordinated clinical guidelines, and specific research aimed
at updating the effective practices in public health.