Clinical, Hematological, and Biochemical Profile in Seropositive Dengue Cases at a Tertiary Care Hospital in Nepal

Background: Dengue virus infection is a major source of morbidity and mortality in the majority of tropical and subtropical nations. In Nepal, the first case of dengue was reported in 2004, followed by numerous outbreaks exerting a critical impact on public health. This study aims to describe the clinical and laboratory characteristics of dengue patients visiting a tertiary care hospital to see the trend of presentation. Method: Hospital based cross-sectional study was conducted among diagnosed cases of dengue from April 2023 to September 2023. A total of 692 patients undergoing testing by commercially available dengue rapid diagnostic tests were recruited and categorized dengue positive (if NS1 and/or IgM positive) and dengue negative (NS1, IgM, and IgG all negative or only IgG positive). The dengue-positive cases were further subdivided into three groups (only NS1 positive, only IgM positive, both NS1 and IgM positive). Additionally, biochemical and hematological analyses were performed, and results were compared between positive and negative cases by using Mann-Whitney U test while subgroups of dengue-positive cases were compared using Kruskal-Wallis H test. Results: Most common symptoms were fever (94.5%) followed by headache (79.8%) and myalgia (74.7%). Among 346 dengue-positive subjects, 53.2% (n = 184) were NS1-only positive, 21.7% (n = 75) were IgM-only positive, and 25.1% (n = 87) were both NS1+IgM positive. Thrombocytopenia (n = 179, 51.7%), leucopenia (n = 99, 28.6%), increased SGPT (n = 182, 52.6%), increased SGOT (n = 188, 54.3%) were seen among dengue positive patients. Leukopenia was more severe in patients with only NS1 positive cases (p = 0.008) whereas thrombocytopenia (p ≤ 0.001) was more severe in patients with both IgM and NS1 positive cases. Conclusion: Our study depicted there is a marked alteration in biochemical and hematological parameters specifically thrombocytopenia, leukopenia, increased transaminase levels, and high prothrombin time seen in dengue positive cases.