Clinical Characteristics of Hospitalized Patients with Dengue Fever in Guangzhou, China

While the WHO has outlined specific dengue clinical phases, detailed real-world comparisons across different clinical phases remain valuable for clinical management. This study evaluates clinical features of dengue hospitalizations during the 2024 outbreak in Guangzhou, China, where recent tracking confirmed a predominant circulation of highly homologous DENV-1.

This is a retrospective study of hospitalized patients with dengue virus infection from May to October 2024 in Guangzhou. Both descriptive and inferential statistics were utilized to compare symptoms and laboratory results among patients in different clinical phases.

Of 151 hospitalized dengue cases, 101 (66.9%), 42 (27.8%), and 8 (5.3%) patients were in the febrile phase, critical phase and recovery phases at admission, respectively. The mean age was 44 years, with 76 (50%) female patients. Fifty-two (34%) patients had comorbidities. Median time from symptom onset to hospital admission was 1 day (IQR: 1-4), with a consequent median hospital length of stay of 5.2 days (3.8-6.5). While fever was the dominant symptom in the febrile phase (67%, P < 0.001), while rash prevalence peaked in the recovery phase (62.5%, P=0.009). Compared to the febrile phase, the critical phase exhibited significantly lower white blood cells (P=0.008), platelets (P<0.001), blood urea nitrogen (P=0.008), fibrinogen (P=0.043), and prothrombin time (P<0.001), but significantly elevated alanine aminotransferase (P=0.028), aspartate aminotransferase (P=0.001), and lactate dehydrogenase (P=0.001).

Despite the limitation of lacking specific viral etiology identification, this descriptive study delineates the distinct symptomatology and macroscopic laboratory kinetics of dengue patients across different WHO clinical stages during the 2024 outbreak. The high prevalence of rash and altered laboratory parameters in the later stages indicate that additional care is required in the later stages of the disease.