P-1807. A Study on Clinical, Laboratory Parameters and Outcome Among Patients Infected with Different Dengue Serotypes in a Tertiary Care Hospital

TL;DR

This study compares clinical and lab features of dengue patients infected with different serotypes in India, finding minimal differences in severity despite varied symptoms and markers.

Contribution

The study provides recent Indian data showing minimal outcome variation across dengue serotypes, despite differing clinical and inflammatory markers.

Findings

DENV2 showed more systemic symptoms and radiological changes compared to other serotypes.

Elevated inflammatory markers were linked to severe dengue, but overall severity and outcomes were similar across serotypes.

Secondary dengue cases had more warning signs than primary infections, but complications were comparable across serotypes.

Abstract

This study aims to assess and compare the clinical presentations, laboratory parameters, radiological findings, and outcomes of adult patients infected with different dengue serotypes presenting to a tertiary care hospital in Kolkata, India, between July 2023 and April 2024Clinical presentations among different Dengue serotypesExamination & Radiological findings among different Dengue serotypes

Clinical presentations among different Dengue serotypes

Examination & Radiological findings among different Dengue serotypes

A prospective observational study was done on 140 dengue-positive patients aged >18 years. Other infections were excluded. Clinical features, laboratory parameters, imaging, and outcomes were analyzed across serotypes using R softwareLaboratory parameters among different Dengue serotypes and Inflammatory markers non severe vs severe DengueDengue severity and complications among different Dengue serotypes

Laboratory parameters among different Dengue serotypes and Inflammatory markers non severe vs severe Dengue

Dengue severity and complications among different Dengue serotypes

140 cases (DENV2:48, DENV3:86, DENV4:6) mean age 34.4±12 years; 55.5% male : 44.5% female. 77 patients needed admission. Hypertension(36%) commonest comorbidity. All comorbidities found no severity difference among three groups. Common symptoms fever (99%), body ache (60%), myalgia (55%), headache (50%), and nausea (45%). Myalgia was more in DENV2 (p=0.009), arthralgia in DENV4 (p=0.04). Hematological, liver function tests, renal function tests were similar across 3 groups, except for higher triglycerides (198 mg/dL) and CRP (38.2 mg/dL) in DENV4; ferritin was lowest in DENV3 (482 ng/mL). On imaging gall bladder wall edema (18%) and splenomegaly (37%) were more seen in DENV2. No significant difference in dengue with warning signs across groups. Severe dengue(n=14) occurred in 14% DENV2 and 8% DENV3, none in DENV4. Secondary dengue (n=24) showed more warning signs than primary (87% vs 44%, p=0.001). Complications like plasma leakage, shock, and bleeding were comparable across serotypes without significant difference. One death occurred in a DENV2 patient due to DSS

DENV2 and DENV3 were predominant serotypes. DENV2 showed more systemic symptoms and notable radiological changes. Elevated inflammatory markers were linked to severity. No major difference in severity or outcome were found across serotypes. Study limitation was no DENV1 and few DENV4 cases. Other studies showed various serotype severity, this study adds to existing knowledge showing minimal outcome variation by serotype. Larger multicentric studies and serotype surveillance are needed to clarify serotype-related risks as dengue virus changes its genes & epidemiology. In my knowledge this is latest study (2023-2024) from India comparing dengue serotypes difference

All Authors: No reported disclosures

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