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A double whammy: The association between comorbidities and severe dengue among adult patients—A matched case-control study

BACKGROUND: Dengue infection is the most prevalent mosquito-borne viral infection globally. Concurrently, there has also been an upsurge of non-communicable comorbidities. We aimed to investigate the association between these comorbidities and the development of severe dengue. METHODS: We performed...

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Autores principales: Ng, Wei Yao, Atan, Rafidah, Mohd Yunos, Nor’azim, bin Md Kamal, Adam Harrish, Roslan, Mohd Hariz, Quah, Kai Yuan, Teh, Kai Xuan, Zaid, Masliza, Kassim, Mahazir, Mariapun, Jeevitha, Ngim, Chin Fang, Dhanoa, Amreeta, Yeo, Tsin Wen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9488767/
https://www.ncbi.nlm.nih.gov/pubmed/36126060
http://dx.doi.org/10.1371/journal.pone.0273071
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author Ng, Wei Yao
Atan, Rafidah
Mohd Yunos, Nor’azim
bin Md Kamal, Adam Harrish
Roslan, Mohd Hariz
Quah, Kai Yuan
Teh, Kai Xuan
Zaid, Masliza
Kassim, Mahazir
Mariapun, Jeevitha
Ngim, Chin Fang
Dhanoa, Amreeta
Yeo, Tsin Wen
author_facet Ng, Wei Yao
Atan, Rafidah
Mohd Yunos, Nor’azim
bin Md Kamal, Adam Harrish
Roslan, Mohd Hariz
Quah, Kai Yuan
Teh, Kai Xuan
Zaid, Masliza
Kassim, Mahazir
Mariapun, Jeevitha
Ngim, Chin Fang
Dhanoa, Amreeta
Yeo, Tsin Wen
author_sort Ng, Wei Yao
collection PubMed
description BACKGROUND: Dengue infection is the most prevalent mosquito-borne viral infection globally. Concurrently, there has also been an upsurge of non-communicable comorbidities. We aimed to investigate the association between these comorbidities and the development of severe dengue. METHODS: We performed a retrospective, case-control study involving 117 cases with severe dengue and 351 controls with non-severe dengue; matched according to gender, age (+/- 5 years old), and admission date (+/- 2 weeks). We analyzed the data using conditional odds ratio (cOR) and adjusted conditional odds ratio (AcOR) using univariate and multivariable conditional logistic regression respectively. RESULTS: Six main comorbidities namely obesity, diabetes mellitus, hypertension, hyperlipidemia, chronic pulmonary disease, and ischemic heart disease were observed among cases and controls. Multivariable conditional logistic regression model found only hypertension to be independently associated with the development of severe dengue (ACOR 2.46; 95% CI:1.09–5.53). Among symptoms at presentation, lethargy, vomiting, bleeding manifestations, and abdominal pain were associated with increased odds of severe dengue, although the associations were not statistically significant. Headache (ACOR: 0:32; 95% CI: 0.21–0.51) and skin rash (ACOR: 0.42; 95% CI: 0.22–0.81) were associated with significantly lower odds of severe dengue. Severe dengue patients were also found to have significantly higher white cell count, urea, creatinine, alanine aminotransferase, aspartate aminotransferase, creatine kinase, and lactate dehydrogenase on admission, while platelet and albumin were significantly lower compared to non-severe dengue patients. CONCLUSIONS: Our study found a significant association between hypertension and the development of severe dengue in adult patients. For clinical practice, this finding suggests that dengue patients with underlying hypertension warrant closer clinical monitoring for deterioration. The association between significant derangement in various laboratory parameters and severe dengue as shown in this study is in keeping with previous reports. While further substantiation by larger prospective studies will be desirable, this association may serve to inform the dengue triaging process.
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spelling pubmed-94887672022-09-21 A double whammy: The association between comorbidities and severe dengue among adult patients—A matched case-control study Ng, Wei Yao Atan, Rafidah Mohd Yunos, Nor’azim bin Md Kamal, Adam Harrish Roslan, Mohd Hariz Quah, Kai Yuan Teh, Kai Xuan Zaid, Masliza Kassim, Mahazir Mariapun, Jeevitha Ngim, Chin Fang Dhanoa, Amreeta Yeo, Tsin Wen PLoS One Research Article BACKGROUND: Dengue infection is the most prevalent mosquito-borne viral infection globally. Concurrently, there has also been an upsurge of non-communicable comorbidities. We aimed to investigate the association between these comorbidities and the development of severe dengue. METHODS: We performed a retrospective, case-control study involving 117 cases with severe dengue and 351 controls with non-severe dengue; matched according to gender, age (+/- 5 years old), and admission date (+/- 2 weeks). We analyzed the data using conditional odds ratio (cOR) and adjusted conditional odds ratio (AcOR) using univariate and multivariable conditional logistic regression respectively. RESULTS: Six main comorbidities namely obesity, diabetes mellitus, hypertension, hyperlipidemia, chronic pulmonary disease, and ischemic heart disease were observed among cases and controls. Multivariable conditional logistic regression model found only hypertension to be independently associated with the development of severe dengue (ACOR 2.46; 95% CI:1.09–5.53). Among symptoms at presentation, lethargy, vomiting, bleeding manifestations, and abdominal pain were associated with increased odds of severe dengue, although the associations were not statistically significant. Headache (ACOR: 0:32; 95% CI: 0.21–0.51) and skin rash (ACOR: 0.42; 95% CI: 0.22–0.81) were associated with significantly lower odds of severe dengue. Severe dengue patients were also found to have significantly higher white cell count, urea, creatinine, alanine aminotransferase, aspartate aminotransferase, creatine kinase, and lactate dehydrogenase on admission, while platelet and albumin were significantly lower compared to non-severe dengue patients. CONCLUSIONS: Our study found a significant association between hypertension and the development of severe dengue in adult patients. For clinical practice, this finding suggests that dengue patients with underlying hypertension warrant closer clinical monitoring for deterioration. The association between significant derangement in various laboratory parameters and severe dengue as shown in this study is in keeping with previous reports. While further substantiation by larger prospective studies will be desirable, this association may serve to inform the dengue triaging process. Public Library of Science 2022-09-20 /pmc/articles/PMC9488767/ /pubmed/36126060 http://dx.doi.org/10.1371/journal.pone.0273071 Text en © 2022 Ng et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Ng, Wei Yao
Atan, Rafidah
Mohd Yunos, Nor’azim
bin Md Kamal, Adam Harrish
Roslan, Mohd Hariz
Quah, Kai Yuan
Teh, Kai Xuan
Zaid, Masliza
Kassim, Mahazir
Mariapun, Jeevitha
Ngim, Chin Fang
Dhanoa, Amreeta
Yeo, Tsin Wen
A double whammy: The association between comorbidities and severe dengue among adult patients—A matched case-control study
title A double whammy: The association between comorbidities and severe dengue among adult patients—A matched case-control study
title_full A double whammy: The association between comorbidities and severe dengue among adult patients—A matched case-control study
title_fullStr A double whammy: The association between comorbidities and severe dengue among adult patients—A matched case-control study
title_full_unstemmed A double whammy: The association between comorbidities and severe dengue among adult patients—A matched case-control study
title_short A double whammy: The association between comorbidities and severe dengue among adult patients—A matched case-control study
title_sort double whammy: the association between comorbidities and severe dengue among adult patients—a matched case-control study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9488767/
https://www.ncbi.nlm.nih.gov/pubmed/36126060
http://dx.doi.org/10.1371/journal.pone.0273071
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