Clinical profile and predictors of Severe Dengue disease: A study from South India

Background: Dengue is endemic and prevalent in tropical and sub-tropical countries including India and can cause significant mortality and morbidity. There are limited studies available on factors associated with severe dengue from India, to investigate the predictors of severe dengue in south Indian patients. Methods: We recruited 334 patients with dengue admitted in Yashoda Hospital, Hyderabad. Study period was between March 2015 and February 2017. Based on clinical symptoms, we divided patients into severe dengue and non-severe dengue. Univariate and multivariate analysis was performed for prognostic factors of severe dengue. Results: Out of 334 patients, there were 186(55.6%) males with mean age 30.3 +/- 14.3 39 years (age range: 10-73 years), severe dengue was seen in 117(35%) and non-severe dengue in 217(65%). Clinical symptoms of diabetes, low platelet count (<50,000mm(3)), melena, skin rash, delayed admission (>5days after onset) elevated hematocrit, lymphadenopathy, hepatomegaly, splenomegaly, convulsions and mortality were significantly associated with severe dengue. After multivariate analysis, diabetes (OR: 2.12; 95% CI:1.34-4.65) (<0.0001), elevated hematocrit (OR: 3.14; 95% CI:2.17-6.14) (<0.0001), skin rashes (OR: 1.99; 95% CI: 1.11-3.55) (<0.0001), melena (OR: 2.59; 95% CI:1.40-4.93) (<0.0001), low platelet count (OR: 6.71; 95% CI:4.12-13.6) (<0.0001), lymphadenopathy (OR: 3.12 95% CI: 1.91-7.85) (<0.0001) and delayed admission (OR: 2.40; 95% CI:1.31-3.41) (<0.0001) were significantly associated with severe dengue disease. Conclusions: In our study, it was established that low platelet count, elevated hematocrit, diabetes, skin rash, melena, lymphadenopathy and delayed in admission (>5days) were independently associated with severe dengue.