Superspecialty Pediatric Hospital & Postgraduate Teaching Institute, Department of Microbiology, Noida, Uttar Pradesh, India.
Superspecialty Pediatric Hospital & Postgraduate Teaching Institute, Department of Pediatrics, Noida, Uttar Pradesh, India.
Rev Soc Bras Med Trop. 2021 Jan 29;54:e05192020. doi: 10.1590/0037-8682-0519-2020. eCollection 2021.
Dengue presents with a variable clinical course, ranging from mild illness to potentially fatal hemorrhage and shock. We aimed to evaluate the capabilities of various hematological parameters observed early in the course of illness for predicting the clinical outcomes of illness.
We retrospectively analyzed the records of children admitted in the pediatric inpatient services of the institute with dengue between 2017 and 2019. We determined the relationships between the hematological parameters observed during the first evaluation and the various clinical outcomes.
We evaluated data from 613 patients (age range, 26 days to 17 years). Of these, 29.85% exhibited fever with warning signs, and 8.97% had severe dengue. Lower values of hemoglobin, platelet count, mean corpuscular volume, mean corpuscular hemoglobin concentration, and mean platelet volume, and higher values of total leukocyte count (TLC), hematocrit, and red cell distribution width variably correlated with numerous clinical outcomes-duration of hospital stay, development of complications, requirement of blood component transfusion, inotropic support, and mortality. Among the parameters, TLC ≥20,000/mL and initial platelet count ≤20,000/mL significantly associated with mortality, with odds ratios (95% confidence interval) of 11.81 (4.21-33.80) and 5.53 (1.90-16.09), respectively.
Hematological parameters observed early during dengue infection may predict its clinical outcomes in infected children. Initial high TLC and low platelet count are potential predictors of fatal outcomes in the course of disease.
登革热的临床病程多变，从轻症到可能致命的出血和休克不等。我们旨在评估疾病早期观察到的各种血液学参数预测疾病临床结局的能力。
我们回顾性分析了 2017 年至 2019 年间在该研究所儿科住院服务部因登革热住院的儿童的记录。我们确定了首次评估期间观察到的血液学参数与各种临床结局之间的关系。
我们评估了 613 名患者（年龄范围 26 天至 17 岁）的数据。其中，29.85%表现出发热伴有警告体征，8.97%患有严重登革热。血红蛋白、血小板计数、平均红细胞体积、平均红细胞血红蛋白浓度和平均血小板体积值较低，总白细胞计数（TLC）、血细胞比容和红细胞分布宽度值较高，与住院时间长短、并发症发生、血液成分输血、正性肌力支持和死亡率等多种临床结局相关。在这些参数中，TLC≥20,000/mL 和初始血小板计数≤20,000/mL 与死亡率显著相关，优势比（95%置信区间）分别为 11.81（4.21-33.80）和 5.53（1.90-16.09）。
登革热感染早期观察到的血液学参数可能预测其临床结局。初始高 TLC 和低血小板计数是疾病过程中致命结局的潜在预测因素。
