Evaluation of Clinical & Hematological Parameters in Patients of Dengue at Tertiary Care Teaching Hospital in Western Gujarat: A Prospective Observational Study

Background: Dengue is a rapidly emerging mosquito-borne virus infection and big public health problem in the tropical countries, Background. It can manifest as a simple febrile illness to a more complicated disease of plasma leakage, bleeding and organ involvement. To achieve better patient outcomes it is important to identify clinical and hematological factors that predict severity early. Material and Methods: This was a prospective, observational study of 250 serologically confirmed dengue patients admitted to tertiary care teaching hospital in western Gujarat. The demographic, clinical, hematological and biochemical parameters of the patients, WHO-2009 classification of the severity of the disease, treatment and clinical results were documented and analyzed with the appropriate statistical methods. Any p-values less than 0.05 were deemed as statistically significant. Results: The cases were predominately young adults (ages 21–30), and there was a slight male predominance of the cases. The common presentation was fever, followed by headache, myalgia, vomiting, abdominal pain and bleeding manifestation. Dengue without warning signs was the most frequently seen clinical type of illness and severe dengue was seen in a lesser proportion of patients. Disease severity was significantly associated with thrombocytopenia, leukopenia, serum transaminases and hypoalbuminemia (p<0.05). Severe dengue had a higher incidence of bleeding manifestations and plasma leakage. Supportive treatment was adequate in most patients and blood component therapy was only necessary in selected patients. Most patients discharged from hospital with a brief stay had completely recovered and there was little mortality. Conclusion: Regular clinical assessments combined with periodic assessment of platelets, hematocrit, leukocytes, liver enzymes and serum albumin are very informative in the early detection of severe Dengue. These are easy, inexpensive, readily available investigations which ensure timely intervention, appropriate patient triage, and better clinical outcomes, especially in resource-limited healthcare settings.

Keywords: Dengue fever, Disease severity, Hematological profile, Serum albumin, Thrombocytopenia.