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–lymphocyte ratio (NLR), the platelet–lymphocyte ratio (PLR), and the neutrophil–lymphocyte*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 = 0.84–0.91), platelet (AUC = 0.89, 95% CI = 0.85–0.93) counts, and NLR (AUC = 0.88, 95% CI = 0.84–0.91) 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 = 0.94–0.98) 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.

Background: COVID-19 has been recognized as an emerging and rapidly evolving health condition. For this reason, efforts to determine changes in laboratory parameters of COVID-19 patients as biomarkers are urgent. Lipids are essential components of the human body, and their modulation has been observed implicated in some viral infections. Methods: To evaluate the clinical diagnosis utility of the lipid profile changes in Mexican COVID-19 patients, the lipid profile of one hundred two COVID-19 positive patients from three hospitals in Culiacan, Sinaloa in northwest Mexico, was analyzed. ROC curves and binary logistic regression analysis were used as a predictive model to determine their clinical diagnostic utility. Results: Significant changes in the serum lipid profile of patients with COVID-19, such as low levels of cholesterol, LDL, and HDL, while high triglycerides and VLDL were observed. The same abnormalities in the lipid profile among non-critical and critical COVID-19 patients were detected. The predictive model analysis suggests that cholesterol and LDL have AUC values of 0.710 and 0.769, respectively, for COVID-19 (p= 0.0002 and p= <0.0001), and LDL low levels might be a risk factor for critical COVID-19 (OR= 2.07, 95% IC: 1.18 to 3.63; p= 0.01). Conclusion: Our findings suggest that low cholesterol and LDL levels could be considered an acceptable predictor for COVID-19, and low levels of LDL might be a risk factor for critical COVID-19 patients.

Coccidioidomycosis is a systemic fungal disease caused by Coccidioides immitis and Coccidioides posadasii. The lungs are the most common and often the initial site of involvement, and the non-pulmonary presentation is infrequent. We describe an unusual case of primary craniocutaneous coccidioidomycosis in a pregnant woman with infected bilateral periorbital nodules, intense pain at paranasal sinuses, and several osteolytic skull lesions. The analysis of 54 cases available in the literature makes us suggest that the area between the United States and Mexico is a risk zone for primary cutaneous coccidioidomycosis.

HLA-G is a physiology and pathologic immunomodulator detrimentally related to cancer. Its gene is heavily transcriptionally and post-transcriptionally regulated by variants located in regulator regions like 3′UTR, being the most studied Ins/Del of 14-bp (rs66554220), which is known to influence the effects of endogen cell factors; nevertheless, the reports are discrepant and controversial. Herein, the relationship of the 14-bp Ins/Del variant (rs66554220) with breast cancer (BC) and its clinical characteristics were analyzed in 182 women with non-familial BC and 221 disease-free women as a reference group. Both groups from western Mexico and sex–age-matched (sm-RG). The rs66554220 variant was amplified by SSP-PCR and the fragments were visualized in polyacrylamide gel electrophoresis. The variant rs66554220 was not associated with BC in our population. However, we suggest the Ins allele as a possible risk factor for developing BC at clinical stage IV (OR = 3.05, 95% CI = 1.16–7.96, p = 0.01); nevertheless, given the small stratified sample size (n = 11, statistical power = 41%), this is inconclusive. In conclusion, the 14-bp Ins/Del (rs66554220) variant of HLA-G is not associated with BC in the Mexican population, but might be related to advanced breast tumors. Further studies are required.

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Hereditary spherocytosis (HS) is one of the most common non-immune hemolytic anemias, and it’s characterized by defects in erythrocyte membrane proteins that result in increased red blood cell fragility and hemolysis. Dengue is an acute viral infection frequently associated with hematologic alterations, including thrombocytopenia and plasma leakage. The coexistence of dengue infection and HS has rarely been reported in the literature. In this report, we describe the case of an 18-year-old male with a history of HS, diagnosed during childhood, who presented with a five-day history of fever and headache. Serologic testing confirmed dengue infection. Laboratory studies revealed severe anemia and thrombocytopenia. Peripheral blood smear showed anisocytosis and spherocytes. Imaging studies demonstrated hepatomegaly, splenomegaly, gallbladder wall edema, and free intraperitoneal fluid. The patient improved with supportive management (such as intravenous Hartmann solution and the transfusion of two red blood cell concentrates) and was discharged without complications. This case highlights a rare comorbidity that exacerbates the hematologic abnormalities in patients with dengue infection.