Long-term sequelae following dengue infection versus SARS-CoV-2 infection in a paediatric population: a retrospective cohort study, 2025, Wee et al

Long-term sequelae following dengue infection versus SARS-CoV-2 infection in a paediatric population: a retrospective cohort study

Wee, Liang En; Lim, Jue Tao; Tan, Janice Yu Jin; Chiew, Calvin; Yung, Chee-Fu; Chong, Chia Yin; Lye, David Chien; Tan, Kelvin Bryan

Background
Long-term post-acute sequelae following SARS-CoV-2 infection in children has been extensively documented. However, while persistence of chronic symptoms following paediatric dengue infection has been documented in small prospective cohorts, population-based studies are limited. We evaluated risk of multi-systemic complications following dengue infection, contrasted against that post-SARS-CoV-2 infection, in a multi-ethnic paediatric Asian population.

Methods
Retrospective population-based cohort study, utilising national COVID-19/dengue registries to construct cohorts of Singaporean children aged 1-17 years with either laboratory-confirmed dengue infection from 1 Jan 2017-31 Oct 2022, or confirmed SARS-CoV-2 infection from 1 Jul 2021 to 31 Oct 2022. Cox-regression was utilized to estimate risks of new-incident cardiovascular/neurological/gastrointestinal/autoimmune/respiratory complications, identified using national healthcare-claims data, at 31-300 days post-dengue infection, versus COVID-19. Risks were reported using two measures: hazard-ratio (HR) and excess-burden (EB).

Results
6,452 dengue-infected children and 260,749 COVID-19 cases were included. Amongst dengue-infected children, there was increased risk of any post-acute gastrointestinal sequelae (adjusted-hazards-ratio, aHR=2.98, 95%CI=1.18-7.18) and specifically, appendicitis (aHR=3.50, 95%CI=1.36-8.99), compared with SARS-CoV-2 infected children. Contrasted against unvaccinated COVID-19 cases, lower risk (aHR=0.42, 95%CI=0.29-0.61) and excess burden (EB=-6.50, 95%CI=-9.80—3.20) of any sequelae, as well as lower risk of respiratory sequelae (aHR=0.17, 95%CI=0.09-0.31) were observed in dengue-infected children.

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

Link | PDF (Open Forum Infectious Diseases) [Open Access]

 

So no healthy controls?