Association of Abnormal Coagulation Tests in Dengue Fever with Clinical Outcomes of The Patients

Irshad, Zareen; Jaffar, Nazish; Zehra, Talat; Zeeshan, Faiza; Tashfeen, Sunila; Sheikh, Asma

doi:10.51253/pafmj.v72i1.4255

Cited by 1 publication

(2 citation statements)

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“…Increased PT and aPTT levels (Table 3 ) are associated with the severity of dengue infection due to a disruption in the coagulation cascade. Elevation of both PT and aPTT was statistically significant in DHF ( p 0.001) compared to DF, which is consistent with previous research [ 37 , 38 ]. Hemorrhagic manifestations, shock and plasma leakage is due to the decreased levels of circulating protein C, S, antithrombin III and elevated levels of tissue factor, thrombomodulin.…”

Section: Discussionsupporting

confidence: 92%

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Evaluation of clinical and laboratory characteristics of dengue viral infection and risk factors of dengue hemorrhagic fever: a multi-center retrospective analysis

Riaz,

Harun,

Mallhi

et al. 2024

BMC Infect Dis

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Background Dengue Viral Infection (DVI) has become endemic in Pakistan since the first major outbreak in Karachi in 1996. Despite aggressive measures taken by relevant authorities, Pakistan has been dealing with a worsening dengue crisis for the past two decades. DHF is severe form of dengue infection which is linked with significant morbidity and mortality. Early identification of severe dengue infections can reduce the morbidity and mortality. In this context we planned current study in which we find out the different factors related with DHF as well as clinical laboratory features of DHF and compare them to DF so that patients can be best evaluated for DHF and managed accordingly at admission. Methods Retrospective study conducted over a period of 6 years (2013–2018) in two tertiary care hospitals in Pakistan. Data were collected by using a pre-structured data collection form. Data were statistically analyzed to determine the clinical and laboratory characteristics of DVI and risk factors of dengue hemorrhagic fever (DHF). Results A total 512 dengue cases (34.05 ± 15.08 years; Male 69.53%) were reviewed. Most common clinical manifestations of DVI were fever (99.60%), headache (89.1%), chills (86.5%), rigors (86.5%), myalgia (72.3%). Less common clinical manifestations were vomiting (52.5%), arthralgia (50.2%) and skin rashes (47.5%). Furthermore, nasal bleeding (44.1%), gum bleeding (32.6%), pleural effusion (13.9%) and hematuria (13.1%) were more profound clinical presentations among DHF patients. Mortality rate was 1.5% in this study. Logistic regression analysis indicated that delayed hospitalization (OR: 2.30) and diabetes mellitus (OR:2.71), shortness of breath (OR:2.21), association with risk groups i.e., living near stagnant water, travelling to endemic areas, living in endemic regions (OR:1.95), and presence of warning signs (OR:2.18) were identified as risk factors of DHF. Statistically we found that there is strong association of diabetes mellitus (DM) with DHF while the patient suffering from DM individually had higher odds (2.71) of developing DHF than patients without disease. Conclusions The current study demonstrated that the clinical and laboratory profiles of DF and DHF are significantly distinct. Significant predictors of DHF were advanced age, diabetes mellitus, ascites, pleural effusion, thick gallbladder and delayed hospitalization. The identification of these factors at early stage provides opportunities for the clinicians to identify high risk patients and to reduce dengue-related morbidity and mortality.

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Section: Discussionsupporting

confidence: 92%

“…Hemorrhagic manifestations, shock and plasma leakage is due to the decreased levels of circulating protein C, S, antithrombin III and elevated levels of tissue factor, thrombomodulin. Similarly, reduction in coagulation such as II, V, VII, VIII, IX, X, antithrombin, and alpha-2 antiplasmin factors was reported in DHF [ 22 , 35 , 38 ].…”

Section: Discussionmentioning

confidence: 76%