SARS-CoV-2 spike antibodies cross-react with dengue virus and enhance infection in vitro and in vivo.

The presence of non-neutralizing antibodies of any dengue serotype increases the severity of subsequent infection by other dengue serotypes. During the SARS-CoV-2 pandemic, the number of symptomatic dengue cases increased in India. We found that antibodies isolated from convalescent plasma from COVID-19 patients enhances DENV2 infection in vitro. CR3022, an antibody against the SARS-CoV-2 spike protein, also elevated DENV2 infection in vitro. In silico protein-protein interactions between spike antibodies and the DENV2 E-protein revealed significant interactions. Likewise, few monoclonal/polyclonal antibodies against SARS-CoV-2 have shown increased dengue infection in vitro. Importantly, AG129 mice infected with SARS-CoV-2 three weeks prior to DENV2 infection showed elevated dengue pathogenesis. This highlights the possibility of elevated infection and symptomatic dengue disease in COVID-19 survivors.