Preprint Review Version 3 Preserved in Portico This version is not peer-reviewed

COVID-19 Virus Infection and Transmission are Observably Less in Highly Dengue-endemic Countries: Can Dengue Vaccines be “Repurposed” to Prevent COVID-19?

Version 1 : Received: 2 April 2020 / Approved: 3 April 2020 / Online: 3 April 2020 (15:48:36 CEST)
Version 2 : Received: 13 April 2020 / Approved: 14 April 2020 / Online: 14 April 2020 (08:49:03 CEST)
Version 3 : Received: 2 May 2020 / Approved: 5 May 2020 / Online: 5 May 2020 (03:00:34 CEST)

A peer-reviewed article of this Preprint also exists.


Global severity maps of ongoing dengue epidemic and COVID-19 pandemic do not overlap. Countries with high dengue endemicity (>1.5 million cases/year) are observably less hit by COVID-19 in terms of infection, transmission and mortality. Based on non-overlap of dengue and COVID-19 severity maps and evidence of SARS-CoV-2 serological cross-reactions with dengue, we wonder whether immediate immunization of susceptible populations in Europe, North America and Asia (China, Iran) with available live-attenuated dengue vaccines, will cue the anti-viral immune response to thwart COVID-19 (viral interference). Risk of developing post-vaccination “Antibody-dependent Enhancement” is low as dengue is not endemic in the aforesaid regions.


Dengue; COVID-19; SARS-CoV-2; epidemiology; infection; mortality; cross-protection; Dengue vaccine; ELISA; Dengvaxia


Biology and Life Sciences, Virology

Comments (3)

Comment 1
Received: 5 May 2020
Commenter: Subhajit Biswas
Commenter's Conflict of Interests: Author
Comment: We have elaborated on the abstract part and made some editings in the main text to enhance clarity.
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Comment 2
Received: 20 June 2020
The commenter has declared there is no conflict of interests.
Comment: In connection to this research, we have done computational analysis on possibilities of interaction between Dengue virus antibodies and SARS-CoV-2 virus and came up with results that further support our hypothesis.

You can read our analysis online, and let us know your comments.

Title of publication: Computational modelling predicts that Dengue virus antibodies can bind to SARS-CoV-2 receptor binding sites: Is pre-exposure to dengue virus protective against COVID-19 severity?


On the basis of our observations that COVID-19 and Dengue severity maps do not tend to overlap and the fact that serological cross-reactivity has been reported for COVID-19 antibodies with Dengue antigen (s), together with results from our computational studies, we are of opinion that serology-based diagnosis needs to be complemented with NAT/virus antigen detection-based tests for definitive diagnosis/sero-surveillance of either disease in regions where both of these viruses are now co-existent.
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Comment 3
Received: 14 July 2020
The commenter has declared there is no conflict of interests.
Comment: Our pilot level results emphasize the importance of NAT and/or virus antigen tests to complement sero-surveillance for definitive diagnosis of COVID-19/Dengue in regions where both viruses are co-endemic.

Please read our latest findings:

Dengue antibodies can cross-react with SARS-CoV-2 and vice versa-Antibody detection kits can give false-positive results for both viruses in regions where both COVID-19 and Dengue co-exist.
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