Relationship between Body Mass Index and Dengue Severity in Hospitalized Adults: Evidence from Bangladesh

This study aimed to evaluate the relationship between body mass index (BMI) and the severity of dengue infection among hospitalized adult patients in Bangladesh. This observational study was carried out at Mymensingh Medical College Hospital in Bangladesh from June 2024 and September 2024. This study enrolled 389 laboratory-confirmed adult dengue patients. At admission, data on demographics, clinical features and lab results were collected and in-hospital outcomes noted. Patients were categorized into normal weight (BMI 18.5-23.0kg/m²) and overweight-obese (BMI ≥23.0 kg/m²) groups using Asian-specific BMI cutoffs. The 2009 'WHO' dengue case definition was used to classify disease severity. The study patients were observed with a median age of 28 years (Range: 18-80) and the majority were male (80.7%). Among the patients, 265 had normal weight and 124 were classified overweight-obese. Overweight-obese patients were comparatively older (median age: 31 vs. 26 years; p<0.001) and also were predominantly male. A higher prevalence of complications was observed in overweight-obese patients including ascites (32.3% vs. 21.1%; p=0.018), plasma leakage (31.5% vs. 20.8%; p=0.022), pleural effusion (24.2% vs. 14.3%; p=0.017) and persistent diarrhea (16.1% vs. 7.9%; p=0.014). Dengue severity distribution was 27.8% without warning signs, 66.8% with warning signs and 5.1% severe cases. The in-hospital mortality rate was 0.8%. BMI was not associated with dengue severity, hospital stay, or mortality (p>0.05). In this single-center study from Bangladesh, overweight and obese patients with dengue exhibited a higher frequency of complications; however, BMI was not significantly associated with dengue severity or in-hospital outcomes.