Correlation of Clinical Severity and Laboratory Parameters with Various Serotypes in Dengue Virus: A Hospital-Based Study

Abstract

Objectives. Dengue fever, being hyperendemic with analogous presentations as in many other acute febrile illnesses, poses a challenge in diagnosis during the acute stage. Additionally, the coexistence of multiple serotypes further complicates the disease prognosis. The study was undertaken to determine the dengue virus serotypes, clinical, and laboratory markers as predictors in the severity of infection. Methods. A prospective study was conducted among 106 patients admitted with acute febrile illness having positive NS1 antigen/IgM ELISA. Clinical data were extracted from medical records including demographics, presence of comorbid conditions, clinical presentation, laboratory investigations, and course including length of hospital stay and outcome. Detection of dengue serotypes was done by multiplex reverse transcriptase polymerase chain reaction (RT_PCR). Results. Out of 106 RT-PCR-confirmed cases, DENV-3 was the most common serotype found in 56 (52.8%) patients, followed by DENV-3 and DENV-4 coinfection in 27 (25.4%) patients. Coinfection with more than one serotype was witnessed in our study. Raised liver enzymes and increased ferritin are good biomarkers in differentiating dengue from severe dengue with cutoff levels for AST (134 U/L), ALT (88 U/L), and ferritin (3670 ng/ml). Musculoskeletal, followed by gastrointestinal, manifestations were comparatively higher than respiratory and cutaneous manifestations. Conclusion. This study provides more information on the dengue serotypes. The clinical spectrum along with laboratory parameters such as ferritin, liver enzymes, platelet can be used as potential biomarkers in prediction of dengue severity. The data demonstrated will be useful in early detection and monitoring of the disease.

Diagnosis and serotyping of dengue using cost-effective high-resolution melting curve based real time PCR

“…The results obtained in the present study was in concordance to the previous report which was carried out using the clinical samples (106 patients) collected during the same period (2019) from Dakshina Kannada district of Karnataka. The study found that about 52.8% of cases were affected with DENV 3 serotype and the least common serotype found was DENV 1 (Rao et al, 2020). The important point to be noted is, all the serotypes existed during the study period, and DENV 3 is most prevalent in this geographical region.…”

“…There are controversial reports regarding the association of DENV serotypes with the dengue severity. One study has reported the absence of link between dengue severity and serotypes (Rao et al, 2020). Few other studies argue that dengue severity is associated with DENV serotype (Vaughn et al, 2000;Kalayanarooj and Nimmannitya, 2000;Endy et al, 2002;Nisalak et al, 2003;Kumaria, 2010;Vicente et al, 2016;Rajesh et al, 2020;Gupta et al, 2021).…”

“…The cost-effectiveness and simplicity of the developed assay due to the use of single pair of primers would be advantageous during epidemiological surveillance and screening of blood donors, where large number of samples have to be tested. As the assay takes lesser time for testing, it will be of a great help in screening during large outbreaks of Dengue like the one that occurred during 2017 and 2019 in Karnataka (Rao et al, 2020;Rai et al, 2021)…”

Alterações hepáticas em decorrência da infecção pelo vírus da Dengue

“…https://www.nucleodoconhecimento.com.br RC: 102781 Disponível em: https://www.nucleodoconhecimento.com.br/saude/alteracoeshepaticas O fígado produz as enzimas AST e ALT que são consideradas marcadores de lesão hepática. Essas transaminases aumentam significativamente na infecção aguda da dengue e podem ser usadas como predição de gravidade da doença em casos agudos(RAO et al, 2020). correlacionando os resultados encontrados nos estudos com as alterações fisiológicas e laboratoriais de pacientes infectados por DENV.…”

“…Essa informação corrobora com os resultados deWardhani et al (2017) que mostram os marcadores de gravidade mais frequentes em crianças do que em adultos. Alguns estudos observaram que as transaminases podem ser aliadas no prognóstico de uma hemorragia na infecção por dengue(RAO et al, 2020).https://www.nucleodoconhecimento.com.br RC: 102781 Disponível em: https://www.nucleodoconhecimento.com.br/saude/alteracoeshepaticas apresentaram aumento de 10 vezes nos pacientes que não sobreviveram em relação aos que sobreviveram. Assim como, os níveis de ALT apresentaram aumento também significativo para esse mesmo grupo, que não sobreviveram, mostrando que as alterações nos níveis plasmáticos dessas enzimas servem como marcadores de gravidade da doença.…”