Dynamic Changes of Platelet and Factors Related Dengue Haemorrhagic Fever: A Retrospective Study in Indonesian

Dengue is a viral infection caused by the dengue virus (DENV). Dengue infection is a self-limited acute febrile illness caused by four serotypes of DENV (DENV-1~4). Early recognition of high-risk patients would be helpful to reduce mortality rates and prevent severe dengue. Our study aimed to identify factors related to dengue hemorrhagic fever (DHF) based on admission-day data, and further to understand the distribution of biochemical laboratory data in dengue patients. This retrospective study was conducted in hospitals in Yogyakarta city, Indonesia, and involved febrile patients who were admitted to the hospital with a diagnosis of dengue during 2018 and 2020. Logistic regression models were used to identify variables related to DHF. In this study, 1087 patients were included as suspected dengue patients, among them 468 had dengue fever (DF) and 619 had DHF. Over half of the DHF patients were males (55.9%) with an average age of 17.9 years, and with a secondary infection (71.3%). By a multivariate analysis, on-admission laboratory data of thrombocytopenia and hemoglobin showed significant association with DHF. Furthermore, DHF patients had significantly prolonged hospitalizations compared to DF patients. In conclusion, on-admission platelet counts and hemoglobin laboratory data are useful as predictors of DHF especially for suspected dengue patients with the limitations of diagnostic tests.

[1]  R. T. Sasmono,et al.  Molecular epidemiology of dengue in North Kalimantan, a province with the highest incidence rates in Indonesia in 2019. , 2021, Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases.

[2]  I. Yoon,et al.  Clinical and epidemiologic characteristics associated with dengue fever in 2011–2016 in Bang Phae district, Ratchaburi province, Thailand , 2021, PLoS neglected tropical diseases.

[3]  V. Desakorn,et al.  Evaluation of Hematocrit in Adults with Dengue by a Laboratory Information System , 2021, Journal of tropical medicine.

[4]  S. Kalayanarooj,et al.  Risk predictors of progression to severe disease during the febrile phase of dengue: a systematic review and meta-analysis , 2021, The Lancet. Infectious diseases.

[5]  L. Lopes,et al.  Factors associated with thrombocytopenia in patients with dengue fever: a retrospective cohort study , 2020, BMJ Open.

[6]  B. Alisjahbana,et al.  Dengue viral infection in Indonesia: Epidemiology, diagnostic challenges, and mutations from an observational cohort study , 2019, PLoS neglected tropical diseases.

[7]  H. Harapan,et al.  Epidemiology of dengue hemorrhagic fever in Indonesia: analysis of five decades data from the National Disease Surveillance , 2019, BMC research notes.

[8]  S. Hay,et al.  The current and future global distribution and population at risk of dengue , 2019, Nature Microbiology.

[9]  P. Tsai,et al.  Dengue virus nonstructural protein 1 activates platelets via Toll-like receptor 4, leading to thrombocytopenia and hemorrhage , 2019, PLoS pathogens.

[10]  S. Gunasena,et al.  Evaluation of biochemical and haematological changes in dengue fever and dengue hemorrhagic fever in Sri Lankan children: a prospective follow up study , 2019, BMC Pediatrics.

[11]  G. Ogg,et al.  Role of NS1 antibodies in the pathogenesis of acute secondary dengue infection , 2018, Nature Communications.

[12]  A. Tantiworawit,et al.  Useful clinical features and hematological parameters for the diagnosis of dengue infection in patients with acute febrile illness: a retrospective study , 2018, BMC Hematology.

[13]  U. Ralapanawa,et al.  Value of peripheral blood count for dengue severity prediction , 2018, BMC Research Notes.

[14]  Hung-Jung Lin,et al.  Predicting the mortality in geriatric patients with dengue fever , 2017, Medicine.

[15]  A. Khan,et al.  Determinants of mortality and prolonged hospital stay among dengue patients attending tertiary care hospital: a cross-sectional retrospective analysis , 2017, BMJ Open.

[16]  G. Ogg,et al.  Pathogenesis of vascular leak in dengue virus infection , 2017, Immunology.

[17]  S. Suharto,et al.  Clinical and virological characteristics of dengue in Surabaya, Indonesia , 2017, PloS one.

[18]  N. M. Dung,et al.  The value of daily platelet counts for predicting dengue shock syndrome: Results from a prospective observational study of 2301 Vietnamese children with dengue , 2017, PLoS neglected tropical diseases.

[19]  S. Bhattacharyya,et al.  Platelet activation determines the severity of thrombocytopenia in dengue infection , 2017, Scientific Reports.

[20]  T. Yeo,et al.  Diabetes, cardiac disorders and asthma as risk factors for severe organ involvement among adult dengue patients: A matched case-control study , 2017, Scientific Reports.

[21]  W. Ko,et al.  A Cohort Study of Adult Patients with Severe Dengue in Taiwanese Intensive Care Units: The Elderly and APTT Prolongation Matter for Prognosis , 2017, PLoS neglected tropical diseases.

[22]  L. Rénia,et al.  Severity of Plasma Leakage Is Associated With High Levels of Interferon &ggr;–Inducible Protein 10, Hepatocyte Growth Factor, Matrix Metalloproteinase 2 (MMP-2), and MMP-9 During Dengue Virus Infection , 2017, The Journal of infectious diseases.

[23]  A. Arbo,et al.  Clinical Characteristics and Risk Factors of Dengue Shock Syndrome in Children , 2016, The Pediatric infectious disease journal.

[24]  Yee‐Shin Lin,et al.  Factors contributing to the disturbance of coagulation and fibrinolysis in dengue virus infection. , 2013, Journal of the Formosan Medical Association = Taiwan yi zhi.

[25]  G. Crane Dengue haemorrhagic fever: diagnosis, treatment, prevention and control , 1999 .