ArticleThe American journal of tropical medicine and hygiene2023
Clinical Features of COVID-19, Dengue, and Influenza among Adults Presenting to Emergency Departments and Urgent Care Clinics-Puerto Rico, 2012-2021.
Article in The American journal of tropical medicine and hygiene, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Differences in clinical characteristics between coronavirus disease 2019 (COVID-19) and influenza: a systematic review and meta-analysis.NPJ primary care respiratory medicine · 2025Pooled it
- Proof-of-Concept Machine Learning Framework for Arboviral Disease Classification Using Literature-Derived Synthetic Data: Methodological Development Preceding Clinical Validation.Healthcare (Basel, Switzerland) · 2026Article
- Clinical Symptom Patterns as Predictors of SARS-CoV-2 Infection in Healthcare Workers in Puerto Rico.International journal of environmental research and public health · 2025Article
- Engineered Nanobodies for early and accurate diagnosis of dengue virus infection.PLoS neglected tropical diseases · 2025Article
- Coinfection with Respiratory Pathogens and Dengue Disease Severity in Puerto Rico, 2012-2024.The American journal of tropical medicine and hygiene · 2025Article
- Antibiotic Use in Pediatric Dengue Cases in Taiwan: A National Administrative Database Analysis.The American journal of tropical medicine and hygiene · 2025Article
- Population-level respiratory virus-virus interactions, Puerto Rico, 2013-2023.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2025Article
- Machine learning for predicting severe dengue in Puerto Rico.Infectious diseases of poverty · 2025Article
- Recommendations for dengue vaccine implementation in the elderly population.Therapeutic advances in vaccines and immunotherapy · 2025Review
- The Angiopoietin-Tie-2 Axis in Children and Young Adults with Dengue Virus Infection in the Philippines.The American journal of tropical medicine and hygiene · 2024Article
- Diagnostic Accuracy of the Abbott BinaxNOW COVID-19 Antigen Card Test, Puerto Rico.Influenza and other respiratory viruses · 2024Article
- Sentinel Enhanced Dengue Surveillance System - Puerto Rico, 2012-2022.Morbidity and mortality weekly report. Surveillance summaries (Washington, D.C. : 2002) · 2024Article
- Epidemiological, virological and clinical characterization of a Dengue/Zika outbreak in the Caribbean region of Costa Rica 2017-2018.Frontiers in cellular and infection microbiology · 2024Article
- Dengue Mimickers: Which Clinical Conditions Can Resemble Dengue Fever?Revista da Sociedade Brasileira de Medicina Tropical · 2024Review
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16 authors.
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Abstract
Dengue and influenza are pathogens of global concern and cause febrile illness similar to COVID-19. We analyzed data from an enhanced surveillance system operating from three emergency departments and an urgent care clinic in Puerto Rico to identify clinical features predictive of influenza or dengue compared with COVID-19. Participants with fever or respiratory symptoms and aged ≥18 years enrolled May 2012-January 2021 with dengue, influenza, or SARS-CoV-2 confirmed by reverse transcriptase polymerase chain reaction were included. We calculated adjusted odds ratios (aORs) and 95% CIs using logistic regression to assess clinical characteristics of participants with COVID-19 compared to those with dengue or influenza, adjusting for age, subregion, and days from illness onset to presentation for clinical care. Among 13,431 participants, we identified 2,643 with dengue (N = 303), influenza (N = 2,064), or COVID-19 (N = 276). We found differences in days from onset to presentation among influenza (2 days [interquartile range: 1-3]), dengue (3 days [2-4]), and COVID-19 cases (4 days [2-7]; P < 0.001). Cough (aOR: 0.12 [95% CI: 0.07-0.19]) and shortness of breath (0.18 [0.08-0.44]) were less common in dengue compared with COVID-19. Facial flushing (20.6 [9.8-43.5]) and thrombocytopenia (24.4 [13.3-45.0]) were more common in dengue. Runny nose was more common in influenza compared with COVID-19 (8.3 [5.8-12.1]). In summary, cough, shortness of breath, facial flushing, and thrombocytopenia helped distinguish between dengue and COVID-19. Although few features distinguished influenza from COVID-19, presentation > 4 days after symptom onset suggests COVID-19. These findings may assist clinicians making time-sensitive decisions regarding triage, isolation, and management while awaiting pathogen-specific testing.
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