{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T05:29:49Z","timestamp":1790832589417,"version":"4.1.0"},"reference-count":19,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,1,12]],"date-time":"2021-01-12T00:00:00Z","timestamp":1610409600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To identify the differential diagnoses of severe COVID\u201019 and the distinguishing characteristics of critically ill COVID\u201019 patients in Reunion Island to help improve the triage and management of patients in this tropical setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective observational study was conducted from 11 March to 4 May 2020 in the only intensive care unit (ICU) authorised to manage COVID\u201019 patients in Reunion Island, a French overseas department located in the Indian Ocean region. All patients with unknown COVID\u201019 status were tested by polymerase chain reaction (PCR) on ICU admission; those who tested negative were transferred to the COVID\u201019\u2010free area of the ICU.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Over the study period, 99 patients were admitted to our ICU. A total of 33 patients were hospitalised in the COVID\u201019 isolation ward, of whom 11 were positive for COVID\u201019. The main differential diagnoses of severe COVID\u201019 were as follows: community\u2010acquired pneumonia, dengue, leptospirosis causing intra\u2010alveolar haemorrhage and cardiogenic pulmonary oedema. The median age of COVID\u201019\u2010positive patients was higher than that of COVID\u201019\u2010negative patients (71 [58\u201374] vs. 54 [46\u201363.5] years, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.045). No distinguishing clinical, biological or radiological characteristics were found between the two groups of patients. All COVID\u201019\u2010positive patients had recently travelled or been in contact with a recent traveller.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In Reunion Island, dengue and leptospirosis are key differential diagnoses of severe COVID\u201019, and travel is the only distinguishing characteristic of COVID\u201019\u2010positive patients. Our findings apply only to the particular context of Reunion Island at this time of the epidemic.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.13542","type":"journal-article","created":{"date-parts":[[2020,12,24]],"date-time":"2020-12-24T11:41:29Z","timestamp":1608810089000},"page":"444-452","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Differential diagnoses of severe COVID\u201019 in tropical areas: the experience of Reunion Island"],"prefix":"10.1111","volume":"26","author":[{"given":"Pauline","family":"Krol","sequence":"first","affiliation":[{"name":"R\u00e9animation Polyvalente Centre Hospitalier Universitaire F\u00e9lix Guyon La R\u00e9union France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"Coolen\u2010Allou","sequence":"additional","affiliation":[{"name":"Service de Pneumologie Centre Hospitalier Universitaire F\u00e9lix Guyon La R\u00e9union 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