436. SARS-CoV-2 Seropositivity and Association with Dengue Severity in Adults

BACKGROUND: The effect of SARS-CoV-2 on the pathogenesis and virulence of the dengue virus is unknown. The cross-reactivity of the immune responses in these infections is an emerging concern, as it may influence the clinical outcomes by establishing cross-immunity or antibody-dependent enhancement. This study evaluated the association between SARS-CoV-2 seropositivity and clinical severity in dengue patients. Fig 1 [Figure: see text] SARS-CoV-2 cases in the region where the study was conducted and adults with dengue presenting to the study site METHODS: We performed a cross-sectional study on confirmed dengue cases admitted at a tertiary care hospital in North India. Baseline demographic data, clinical severity, past history of symptomatic COVID infection, and COVID-19 vaccination were noted. IgG antibodies against the receptor binding domain (RBD) of the SARS-CoV-2 virus were measured in all patients. The association between the SARS-CoV-2 antibody titer and severity of dengue was statistically analyzed using one-way ANOVA - Kruskal Wallis followed by Dunn's multiple comparisons, with a p-value less than 0.05 considered statistically significant. RESULTS: A total of 62 confirmed dengue patients were enrolled in the study (September 2021–December 2021). The median age of the study population was 27 years (IQR: 21–35 years), with a male preponderance of 64.5%. According to WHO dengue severity criteria, 30.6% of patients had dengue without warning signs, 50% had dengue with warning signs, and 19.3% had features suggestive of severe dengue. All patients were seropositive for IgG COVID antibodies, with a median titer of 2700 AU/ml (IQR 900–8100). We observed no statistically significant difference in overall SARS-CoV-2 antibody responses among the three dengue severity groups (p-value 0.9). Table 1 [Figure: see text] Demographic and clinical characteristics of study population and comparison of presentation with varying severity of dengue Table 2 [Figure: see text] Association of SARS CoV2 infection and COVID vaccination with dengue severity Fig 2 [Figure: see text] Effect of COVID-19 vaccination on SARC-CoV-2 specific antibodies in acute dengue patients. Acute dengue patients categorized as non-vaccinated (Green circles, N=12), single (Red circles, N=12) and double dose vaccinated (Blue circles, N=24) with SARS-CoV-2 vaccines. Yellow triangle represents severe dengue (N=11). (A-B) Graph demonstrates the spread of SARS-CoV-2 binding IgG in three groups respectively. Dotted line represents the cut-off for IgG positivity CONCLUSION: This study concludes that SARS-CoV-2 seropositivity is not associated with clinical severity in dengue patients. This may imply that past infection with COVID or vaccination against COVID does not alter the severity of dengue. Fig 3 [Figure: see text] Association of SARS CoV2 infection COVID vaccination and COVID antibody titer with dengue severity DISCLOSURES: All Authors: No reported disclosures