Delayed diagnosis of malaria, dengue as Covid-19 co-infection may lead to miscarriage – Hindustan Times

Late diagnosis of Covid-19 infection with dengue and malaria in pregnant women can lead to health complications including miscarriage, revealed a study conducted by the Indian Council of Medical Research-National Institute for Research in Reproductive Health (ICMR-NIRRH), Parel in association with BYL Nair Hospital.

Covid-19 infection shares similar symptoms with mosquito-borne diseases such as dengue and malaria. In both cases, patients develop symptoms like fever, nausea, vomiting, body ache among others, which often lead to confusion and misdiagnosis. Often when a pregnant woman gets diagnosed with Covid-19, doctors dont test them for dengue and malaria, which delays the diagnosis of the co-infection.

Taking such incidences into account, the researchers conducted a study on three pregnant women infected by Sars-CoV-2, the virus that causes Covid-19 infection. Two of them had co-infection of malaria while the third patient had dengue. The study, Co-infection of malaria and dengue in pregnant women with Sars-Cov-2, has been published in the International Journal of Gynaecology and Obstetrics journal on Saturday.

Co-infections of malaria and dengue or any other monsoon-related illnesses with Sars-CoV-2 infection can be misdiagnosed as all have similar kinds of symptoms and presentations. So all symptomatic Covid-19 cases with fever should be investigated for other common Infections in endemic regions, both in the general population and in pregnant women, to avoid complications, said Dr Rahul Gajbhiye, a scientist at ICMR-NIRRH and principal investigator of the study, in response to an email.

During their study, they found a case of a pregnant woman who had tested positive for Covid-19. Later, when her condition didnt improve, doctors tested her for malaria and to their surprise, she tested positive for the disease. However, it was too late and she soon started bleeding and suffered a miscarriage. The researchers believe that if she was diagnosed earlier with malaria, her baby could have been saved.

Co-infection could be the reason for miscarriage, as malaria is known to cause miscarriages. Along with co-infection, she was suffering from hypertension in pregnancy, which also could be responsible for the miscarriage, said Dr Niraj Mahajan, associate professor at BYL Nair Hospital and another principal investigator of the study.

As Covid-19 infection is spreading to rural parts of India, the researchers cautioned doctors to be more vigilant for early identification of co-infections such as malaria and dengue to control fatality rate among pregnant women.

Dengue or malaria requires a completely different clinical management protocol to that of Covid-19. Delay in diagnosis can lead to other life-threatening complications such as disseminated intravascular coagulation (DIC), renal failure, intrauterine growth retardation (IUGR) among others, said Dr Smita Mahale, director, ICMR-NIRRH.

Dr Ashok Anand, head of the department, obstetrics and gynaecology at Sir JJ Group of Hospitals, said, As a precaution, it is necessary to test pregnant women with Covid-19 along with other seasonal ailments. With timely diagnosis and treatment, we can control the cases of miscarriages among co-infected mothers.

ICMR-NIRRH, in collaboration with the Brihanmumbai Municipal Corporation (BMC), has started a registry of pregnant women with Covid-19 called PregCOVID (https://pregcovid.com/) as a response to Covid-19 pandemic. The study has been conducted by collecting the required data from the portal.

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Delayed diagnosis of malaria, dengue as Covid-19 co-infection may lead to miscarriage - Hindustan Times

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