{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:10:36Z","timestamp":1791850236045,"version":"4.3.4"},"reference-count":87,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2022,8,25]],"date-time":"2022-08-25T00:00:00Z","timestamp":1661385600000},"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>Thrombocytopenia and platelet dysfunction commonly occur in both dengue and COVID-19 and are related to clinical outcomes. Coagulation and fibrinolytic pathways are activated during an acute dengue infection, and endothelial dysfunction is observed in severe dengue. On the other hand, COVID-19 is characterised by a high prevalence of thrombotic complications, where bleeding is rare and occurs only in advanced stages of critical illness; here thrombin is the central mediator that activates endothelial cells, and elicits a pro-inflammatory reaction followed by platelet aggregation. Serological cross-reactivity may occur between COVID-19 and dengue infection. An important management aspect of COVID-19-induced immunothrombosis associated with thrombocytopenia is anticoagulation with or without aspirin. In contrast, the use of aspirin, nonsteroidal anti-inflammatory drugs and anticoagulants is contraindicated in dengue. Mild to moderate dengue infections are treated with supportive therapy and paracetamol for fever. Severe infection such as dengue haemorrhagic fever and dengue shock syndrome often require escalation to higher levels of support in a critical care facility. The role of therapeutic platelet transfusion is equivocal and should not be routinely used in patients with dengue with thrombocytopaenia and mild bleeding. The use of prophylactic platelet transfusion in dengue fever has strained financial and healthcare systems in endemic areas, together with risks of transfusion-transmitted infections in low- and middle-income countries. There is a clear research gap in the management of dengue with significant bleeding.<\/jats:p>","DOI":"10.3390\/tropicalmed7090210","type":"journal-article","created":{"date-parts":[[2022,8,31]],"date-time":"2022-08-31T02:09:36Z","timestamp":1661911776000},"page":"210","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Coagulopathy of Dengue and COVID-19: Clinical Considerations"],"prefix":"10.3390","volume":"7","author":[{"given":"Amin","family":"Islam","sequence":"first","affiliation":[{"name":"Department of Haematology, Mid & South Essex University Hospital NHS Foundation Trust, Prittlewell Chase, Westcliff-on-Sea SS0 0RY, UK"},{"name":"Department of Haematology, Queen Mary University of London, Mile End Road, London E1 3NS, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Cockcroft","sequence":"additional","affiliation":[{"name":"Department of Haematology, Mid & South Essex University Hospital NHS Foundation Trust, Prittlewell Chase, Westcliff-on-Sea SS0 0RY, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4732-9412","authenticated-orcid":false,"given":"Shereen","family":"Elshazly","sequence":"additional","affiliation":[{"name":"Department of Haematology, Mid & South Essex University Hospital NHS Foundation Trust, Prittlewell Chase, Westcliff-on-Sea SS0 0RY, UK"},{"name":"Adult Haemato-Oncology Unit, Faculty of Medicine, Ainshams University, Cairo 11566, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javeed","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Microbiology and Virology, Mid & South Essex University Hospital NHS Foundation Trust, Westcliff-on-Sea SS0 0RY, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Joyce","sequence":"additional","affiliation":[{"name":"Department of Haematology, Mid & South Essex University Hospital NHS Foundation Trust, Prittlewell Chase, Westcliff-on-Sea SS0 0RY, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huque","family":"Mahfuz","sequence":"additional","affiliation":[{"name":"Department of Haematology and Oncology, Combined Military Hospital, Dhaka 1206, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tasbirul","family":"Islam","sequence":"additional","affiliation":[{"name":"Department of Pulmonology and Critical Care Medicine, Indiana School of Medicine, Lafayette, IN 47907, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2286-5139","authenticated-orcid":false,"given":"Harunor","family":"Rashid","sequence":"additional","affiliation":[{"name":"National Centre for Immunisation Research and Surveillance, The Children\u2019s Hospital at Westmead, Westmead, NSW 2145, Australia"},{"name":"Sydney Institute for Infectious Diseases, The University of Sydney, Westmead, NSW 2145, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3917-4417","authenticated-orcid":false,"given":"Ismail","family":"Laher","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Pharmacology & Therapeutics, Faculty of Medicine, The University of British Colombia, Vancouver, BC V6T 1Z3, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e2161","DOI":"10.1002\/rmv.2161","article-title":"COVID-19 and Dengue: Double Punches for Dengue-Endemic Countries in Asia","volume":"31","author":"Harapan","year":"2021","journal-title":"Rev. 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