Arshad Hareem, Bashir Mahvish, Mushtaq Uzema S, Imtiaz Hafsa, Rajpar Rahimeen, Alam Muhammad Fiyaz, Fatima Saher, Rehman Anjum, Abbas Kiran, Talpur Abdul Subhan
Department of Medicine, Jinnah Sindh Medical University, Karachi, PAK.
Department of Medicine, Jinnah Postgraduate Medical Centre, Karachi, PAK.
Cureus. 2022 Jul 9;14(7):e26677. doi: 10.7759/cureus.26677. eCollection 2022 Jul.
Background Early diagnosis and prompt treatment are critical to reducing overall morbidity and mortality associated with dengue fever. Thus, to better understand the condition, the present study was conducted to assess the clinical signs and symptomatology associated with dengue fever in patients in a tertiary care hospital. Methods This prospective observational study was conducted at a tertiary care hospital in Karachi, Pakistan between July and December 2021. All patients who tested positive for the dengue virus either based on antigen or antibodies were included in the study. Convenient sampling was used. A structured proforma was used for data collection. Microsoft Excel (Microsoft Corporation, Redmond, WA) and Statistical Package for the Social Sciences (SPSS, IBM Corp., Armonk, NY) were used for the entry and analysis of data, respectively. Results More than half of the patients were suffering from fever (82.5%), headache/body ache/joint pain (80.5%), and vomiting (55%). Bleeding was observed in 16 (8%) patients and was directly related to platelet count (OR: 0.981; 95% CI: 0.971-0.992), and more than half of the patients (56%) required platelet transfusion. Laboratory values included a mean platelet count of 145.22 ± 90.36 thousand, a mean total leukocyte count (TLC) of 6.87 ± 5.76 thousand, and a mean hemoglobin level of 13.71 ± 2.11 g/dl. Of the patients, 171 (85.5%) individuals tested positive for antigen nonstructural protein 1 (Ns1Ag), and 68 (34%) tested positive for either immunoglobulin G (IgG) or immunoglobulin M (IgM), or both dengue-specific antibodies. Those with dengue-specific antibodies were less likely to bleed as 6.2% were IgG and IgM positive and 31.2% were positive for both antibodies. The regression model showed a significant relationship between bleeding and platelet transfusion (p < 0.001), hospital stay (p < 0.005), and diarrhea (p < 0.001). Conclusion In conclusion, the study revealed that males were more frequently infected with the virus as compared to females. Furthermore, fever, headache/joint pain/body aches, diarrhea, and low platelet count are the major clinical and laboratory outcomes. Patients with a low level of platelets are more prone to bleeding, and platelet transfusion increased survival chances in such patients.
背景 早期诊断和及时治疗对于降低登革热相关的总体发病率和死亡率至关重要。因此，为了更好地了解这种疾病，本研究旨在评估一家三级护理医院中登革热患者的临床体征和症状。方法 这项前瞻性观察性研究于2021年7月至12月在巴基斯坦卡拉奇的一家三级护理医院进行。所有基于抗原或抗体检测出登革热病毒呈阳性的患者均纳入研究。采用方便抽样法。使用结构化表格进行数据收集。分别使用Microsoft Excel（微软公司，华盛顿州雷德蒙德）和社会科学统计软件包（SPSS，IBM公司，纽约州阿蒙克）进行数据录入和分析。结果 超过一半的患者出现发热（82.5%）、头痛/身体疼痛/关节疼痛（80.5%）和呕吐（55%）。16名（8%）患者出现出血症状，且出血与血小板计数直接相关（比值比：0.981；95%置信区间：0.971 - 0.992），超过一半的患者（56%）需要输血治疗。实验室检查值包括平均血小板计数为145.22±90.36千、平均白细胞总数（TLC）为6.87±5.76千以及平均血红蛋白水平为13.71±2.11 g/dl。在这些患者中，171名（85.5%）个体的抗原非结构蛋白1（Ns1Ag）检测呈阳性，68名（34%）个体的免疫球蛋白G（IgG）或免疫球蛋白M（IgM）或两种登革热特异性抗体检测呈阳性。那些患有登革热特异性抗体的患者出血可能性较小，因为6.2%的患者IgG和IgM呈阳性，31.2%的患者两种抗体均呈阳性。回归模型显示出血与输血治疗（p < 0.001）、住院时间（p < 0.005）和腹泻（p < 0.001）之间存在显著关系。结论 总之，研究表明男性比女性更易感染该病毒。此外，发热、头痛/关节疼痛/身体疼痛、腹泻和血小板计数低是主要的临床和实验室检查结果。血小板水平低的患者更容易出血，输血治疗可提高此类患者的生存几率。
