{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T05:30:52Z","timestamp":1791264652098,"version":"4.1.0"},"reference-count":58,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2022,1,30]],"date-time":"2022-01-30T00:00:00Z","timestamp":1643500800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>COVID-19 and dengue disease are challenging to tell apart because they have similarities in clinical and laboratory features during the acute phase of infection, leading to misdiagnosis and delayed treatment. The present study evaluated peripheral blood cell count accuracy to distinguish COVID-19 non-critical patients from non-severe dengue cases between the second and eleventh day after symptom onset. A total of 288 patients infected with SARS-CoV-2 (n = 105) or dengue virus (n = 183) were included in this study. Neutrophil, platelet, and lymphocyte counts were used to calculate the neutrophil\u2013lymphocyte ratio (NLR), the platelet\u2013lymphocyte ratio (PLR), and the neutrophil\u2013lymphocyte*platelet ratio (NLPR). The logistic regression and ROC curves analysis revealed that neutrophil and platelet counts, NLR, LPR, and NLPR were higher in COVID-19 than dengue. The multivariate predictive model showed that the neutrophils, platelets, and NLPR were independently associated with COVID-19 with a good fit predictive value (p = 0.1041). The neutrophil (AUC = 0.95, 95% CI = 0.84\u20130.91), platelet (AUC = 0.89, 95% CI = 0.85\u20130.93) counts, and NLR (AUC = 0.88, 95% CI = 0.84\u20130.91) were able to discriminate COVID-19 from dengue with high sensitivity and specificity values (above 80%). Finally, based on predicted probabilities on combining neutrophils and platelets with NLR or NLPR, the adjusted AUC was 0.97 (95% CI = 0.94\u20130.98) to differentiate COVID-19 from dengue during the acute phase of infection with outstanding accuracy. These findings might suggest that the neutrophil, platelet counts, and NLR or NLPR provide a quick and cost-effective way to distinguish between dengue and COVID-19 in the context of co-epidemics in low-income tropical regions.<\/jats:p>","DOI":"10.3390\/tropicalmed7020020","type":"journal-article","created":{"date-parts":[[2022,1,31]],"date-time":"2022-01-31T01:46:21Z","timestamp":1643593581000},"page":"20","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["The Usefulness of Peripheral Blood Cell Counts to Distinguish COVID-19 from Dengue during Acute Infection"],"prefix":"10.3390","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8280-9812","authenticated-orcid":false,"given":"Juan Fidel","family":"Osuna-Ramos","sequence":"first","affiliation":[{"name":"Department of Infectomics and Molecular Pathogenesis, Center for Research and Advanced Studies (CINVESTAV-IPN), Ciudad de M\u00e9xico 07360, Mexico"},{"name":"Escuela de Medicina, Universidad Aut\u00f3noma de Durango Campus Culiac\u00e1n, Culiac\u00e1n Rosales 80050, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2379-8591","authenticated-orcid":false,"given":"Jos\u00e9 Manuel","family":"Reyes-Ruiz","sequence":"additional","affiliation":[{"name":"Unidad M\u00e9dica de Alta Especialidad, Hospital de Especialidades No. 14, Centro M\u00e9dico Nacional \u201cAdolfo Ruiz Cortines\u201d, Instituto Mexicano del Seguro Social (IMSS), Veracruz 91897, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis Antonio","family":"Ochoa-Ram\u00edrez","sequence":"additional","affiliation":[{"name":"\u201cBernardo J Gast\u00e9lum\u201d, Servicios de Salud de Sinaloa, Hospital General de Culiac\u00e1n, Culiac\u00e1n Rosales 80030, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1415-6260","authenticated-orcid":false,"given":"Luis Adri\u00e1n","family":"De Jes\u00fas-Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Department of Infectomics and Molecular Pathogenesis, Center for Research and Advanced Studies (CINVESTAV-IPN), Ciudad de M\u00e9xico 07360, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7500-7571","authenticated-orcid":false,"given":"Rosal\u00edo","family":"Ramos-Pay\u00e1n","sequence":"additional","affiliation":[{"name":"Facultad de Ciencias Qu\u00edmico-Biol\u00f3gicas, Universidad Aut\u00f3noma de Sinaloa, Culiac\u00e1n Rosales 80040, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos Noe","family":"Farfan-Morales","sequence":"additional","affiliation":[{"name":"Department of Infectomics and Molecular Pathogenesis, Center for Research and Advanced Studies (CINVESTAV-IPN), Ciudad de M\u00e9xico 07360, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandra","family":"Romero-Utrilla","sequence":"additional","affiliation":[{"name":"Departamento de Anatom\u00eda Patol\u00f3gica, Instituto Mexicano del Seguro Social (IMSS), Culiac\u00e1n Rosales 80220, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Efr\u00e9n Rafael","family":"R\u00edos-Burgue\u00f1o","sequence":"additional","affiliation":[{"name":"\u201cBernardo J Gast\u00e9lum\u201d, Servicios de Salud de Sinaloa, Hospital General de Culiac\u00e1n, Culiac\u00e1n Rosales 80030, Mexico"},{"name":"Departamento de Anatom\u00eda Patol\u00f3gica, Hospital Civil de Culiac\u00e1n, Centro de Investigaci\u00f3n y Docencia en Ciencias de la Salud, Universidad Aut\u00f3noma de Sinaloa, Culiac\u00e1n Rosales 80030, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9","family":"Rodr\u00edguez-Mill\u00e1n","sequence":"additional","affiliation":[{"name":"\u201cBernardo J Gast\u00e9lum\u201d, Servicios de Salud de Sinaloa, Hospital General de Culiac\u00e1n, Culiac\u00e1n Rosales 80030, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6785-2035","authenticated-orcid":false,"given":"Rosa Mar\u00eda","family":"del \u00c1ngel","sequence":"additional","affiliation":[{"name":"Department of Infectomics and Molecular Pathogenesis, Center for Research and Advanced Studies (CINVESTAV-IPN), Ciudad de M\u00e9xico 07360, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jes\u00fas Salvador","family":"Velarde-F\u00e9lix","sequence":"additional","affiliation":[{"name":"\u201cBernardo J Gast\u00e9lum\u201d, Servicios de Salud de Sinaloa, Hospital General de Culiac\u00e1n, Culiac\u00e1n Rosales 80030, 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