ArticleThe Lancet regional health. Western Pacific2025
Risk of dengue following prior SARS-CoV-2 infection: a population-based cohort study.
Article in The Lancet regional health. Western Pacific, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Proteomic signals are not equal clinical phenotypes: redefining evidence standards in arbovirus-SARS-CoV-2 cross-reactivity.Frontiers in immunology · 2026Review
Corrections and comments
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: DENV-infection and SARS-CoV-2 are now endemic in tropical regions; interactions may exist, given antigenic cross-reactivity and cross-protection. Risk of subsequent DENV-infection following prior COVID-19 was evaluated in a population-based adult cohort. Methods: Retrospective cohort study including all Singaporeans ≥18 years. National registries were used to construct contemporaneous SARS-CoV-2-infected/test-negative cohorts from 1st Sept 2021-31st Dec 2022 during Delta/Omicron emergence. COVID-19 vaccination status was classified using the national-immunization-registry. Risk of DENV-infection recorded in the national registry 31-300 days post-COVID-19 was contrasted against test-negatives using overlap-weighted Cox regression. Risk of other infections (invasive-pneumococcal-disease/tuberculosis/melioidosis/leptospirosis) were assessed as negative-outcome controls, and risk of DENV-infection post-influenza vaccination was assessed as a negative-exposure control. Findings: 1,324,250 COVID-19 cases (predominantly vaccine-breakthrough mild Omicron infections) and 1,434,851 test-negatives were included. Significantly increased risk of DENV-infection was observed 31-300 days post-COVID-19 (adjusted-hazards-ratio, aHR = 1.10[95%CI = 1.05-1.15]), during a DENV3 surge. Excess-burden of DENV-infection post-COVID-19 was 0.36 cases (95%CI = 0.11-0.61) per-1000-individuals. Risks of subsequent DENV-infection were numerically highest in unvaccinated COVID-19 cases but not elevated in doubly-boosted cases (≥4 vaccine-doses). Risk of negative-outcome controls (other-infections) was not significantly elevated 31-300 days post-COVID-19, and risk of DENV-infection was not significantly elevated post-influenza vaccination. Interpretation: Increased risk of DENV-infection (primarily DENV3) was observed up to 300 days post-SARS-CoV-2 infection (predominantly Omicron). While not irrefutable proof for possible antibody-dependent enhancement of DENV3-infection post-Omicron COVID-19, given modest effect sizes, future studies can shed more light on potential interactions. Public health strategies (e.g., vaccination) remain important in tropical/subtropical regions where COVID-19/DENV are now endemic. Funding: National-Medical-Research-Council, Singapore.
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