Clinical and laboratory characteristics of severe dengue and its comorbidities in Dhaka: a case-control study

The prevalence of dengue in Bangladesh has markedly risen, resulting in the most lethal epidemic in 2023 and persistently elevated levels in 2024. Regardless of stringent control measures, dengue persists with comorbidities in Dhaka City. This research explored the correlation between laboratory findings and clinical parameters with severe dengue infection.

A case-control study was performed on 435 dengue patients (145 cases with severe dengue and 290 controls with non-severe dengue) hospitalized in medical college hospitals in Dhaka City from July to December 2024. Participants were matched by age (±5 years), sex, and admission date (±2 weeks). Univariate and multivariable logistic regression analyses were conducted to find out factors associated with dengue severity.

Comorbidities, such as chronic pulmonary disease (AOR: 2.14; 95% confidence interval (CI): 0.90-5.10), were associated with an increased odds of severe dengue. Symptoms such as abdominal pain (AOR: 2.30; 95% CI: 1.45-3.68), lethargy (AOR: 2.70; 95% CI: 1.35-5.47), and nausea (AOR: 2.21; 95% CI: 1.15-4.22) were associated with increased dengue infection severity. Severe dengue cases exhibited an elevation in serum creatinine, ALT, AST, and pulse rate, but total bilirubin, albumin, and globulin levels were associated with a reduced odds of severity.

This study delineates characteristics associated with severe dengue infection, including comorbidities, such as chronic pulmonary disease, and signs and symptoms, such as abdominal pain, lethargy, and nausea. Laboratory results indicating higher serum creatinine, liver enzymes, and pulse rate, coupled with decreased total bilirubin, albumin, and globulin, were significantly associated with severity. These findings emphasize the significance of early surveillance, especially in patients with comorbidities, and offer critical insights for enhancing the management of severe dengue. Future studies should investigate the transition from non-severe to severe dengue.