Prognostic indicators associated with progresses of severe dengue

Area of Science:

• Infectious Diseases
• Clinical Medicine
• Virology

Background:

• Dengue progression can be abnormal, particularly during the critical phase, leading to shock, severe bleeding, and organ failure.
• Identifying prognostic indicators for severe dengue is essential for timely intervention and improved patient outcomes.

Purpose of the Study:

• To evaluate prognostic laboratory indicators for severe dengue based on disease progression phases.
• To identify early warning signs for severe dengue to guide clinical management.

Main Methods:

• A cross-sectional study involving 326 patients (aged 6+) hospitalized within the first 3 days of illness.
• Confirmed Dengue virus using RT-PCR, monitoring clinical manifestations, and evaluating laboratory parameters (hematocrit, WBC, platelets, albumin, liver enzymes, bilirubin, coagulation profile, creatinine) during febrile and critical phases.
• Multivariate logistic regression was used to identify independent factors associated with severe dengue.

Main Results:

• During the first 3 days of illness, low platelet count (≤ 100 G/L) and low serum albumin (< 35 g/L) were significant indicators of severe dengue.
• From day 4-6, elevated AST (> 400 U/L), elevated ALT (> 400 U/L), low serum albumin (< 35 g/L), and elevated total bilirubin (> 17 μmol/L) were associated with severe dengue.
• Odds ratios ranged from 2.2 to 6.6 for these indicators, highlighting their predictive value.

Conclusions:

• Prognostic laboratory indicators for severe dengue vary with disease progression.
• Platelet count and serum albumin are key indicators in the early febrile phase (first 3 days).
• Liver enzymes (AST, ALT), albumin, and bilirubin are crucial indicators during the critical phase (days 4-6).