Clinical profile and early severity predictors of dengue fever: Current trends for the deadliest dengue infection in Bangladesh in 2022.

OBJECTIVES

In 2022, Bangladesh had the highest dengue-related fatality (281). This study evaluated clinical profiles to detect early changes to predict dengue fever severity.

METHODS

This prospective observational study was performed in four government hospitals from June to November 2022 in Dhaka. Febrile patients admitted within 4th day of illness were recruited if they had a confirmed dengue viral infection either by by positive dengue nonstructural protein antigen or anti-dengue immunoglobulin (Ig)M antibody.

RESULTS

We divided 308 patients with confirmed dengue into two groups: 232 (74.3%) in nonsevere dengue and 76 (24.7%) in severe dengue. Men were 205 (66.6%), and the most affected age group was 21-30 years (47.7%). Patients with severe dengue reported a higher number of nausea 80.3%, coughs 57.9%, abdominal pain 56.6%, persistent vomitting 53.9%, dyspnea 35.5%, diarrhea 28.9%, and skin rash at 27.6%. In addition, the disease's febrile phase (≤4 days) showed thrombocytopenia (odds ratio [OR] 6.409, 95% CI 2.855-14.386, p <0.001), hemoconcentration (OR 3.428, 95% CI 1.030-11.405, p 0.045), and hypotension (OR 5.896, 95% CI 1.203-28.897, p 0.029) were associated severe disease.

CONCLUSIONS

Hypotension, thrombocytopenia, and hemoconcentration during the febrile phase might indicate progression towards severe disease.