As the coronavirus pandemic moves into the tenth month, all need to be cognizant of the co-infection that can occur with COVID-19, AIIMS Director Dr. Randeep Guleria said on October 7, as the apex institute witnessed dengue and tuberculosis infection in patients affected with coronavirus.

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"Co-infection with COVID-19 is an important issue as we are now seeing patients with COVID-19 who have other infections. It becomes a bigger challenge as far managing COVID-19 and dengue is concerned," said Dr. Guleria, who is also the part of a core team monitoring the pandemic. It is also difficult to distinguish symptoms of the two diseases due to overlapping initial clinical presentations and laboratory parameters, say experts. According to Dr. Pawan Tiwari, Assistant Professor at AIIMS' Department of Pulmonary, Critical Care and Sleep Medicine, co-infection is an important concern, especially in severe COVID-19 cases.

He also cited preliminary data of AIIMS on co-infections in 4,200 patients, which showed that 32 patients were diagnosed during admission with extra-pulmonary or pulmonary tuberculosis, 35 had latent tuberculosis, 27 had HIV, 12 had hepatitis-B and 11 had dengue. However, he clarified: "There is no data on whether these infections are bystanders or increase the severity of COVID-19."

"Infection like dengue and influenza have seasonality and co-infection increasingly has been reported. Identifying and managing them is important. HIV, and hepatitis can also be looked for by the doctors," he added. According to another recent study on 4,000 COVID-19 hospital patients, seven percent had bacterial co-infection, 3 percent had viral co-infection, and 4-5 percent had fungal co-infection. Another study with 67 patients, showed 30 patients had co-infection.

This comes at a time when the capital is registering a spike in both dengue and COVID-19 cases as per Health Department data. The city reported 54 cases of dengue in the past week, taking the total tally for this season to 266, as per the vector-borne disease report issued by the municipal corporations.