Severity of Dengue Viral Infection Based on Clinical and Hematological Parameters among Pakistani Patients

Faiz Ul Haq Department of Microbiology, University of Health Sciences, Lahore, Pakistan;

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Muhammad Imran Department of Microbiology, University of Health Sciences, Lahore, Pakistan;

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Zeenaf Aslam Institute of Nursing Sciences, Khyber Medical University, Peshawar, Pakistan;

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Farhan Mukhtar University College of Nursing, The Islamia University of Bahawalpur, Bahawalpur, Pakistan;

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Kokab Jabeen Department of Pathology, Ameer Ud Din Medical College, Lahore, Pakistan;

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Mahnoor Chaudhry Department of Pathology, Ameer Ud Din Medical College, Lahore, Pakistan;

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Saeed Ur Rahman Department of Nursing, University of Health Sciences, Lahore, Pakistan;

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Nasir Muhammad Department of Hematology, University of Health Sciences, Lahore, Pakistan

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ABSTRACT.

The global burden of dengue infections has increased dramatically. Early diagnosis of dengue infection is critical to proper medical management to avoid further complications in patients. This study was geared to assess the severity of dengue infections based on clinical and hematological examinations. A cross-sectional study was conducted among febrile patients with dengue infection in a teaching hospital in Pakistan. Blood samples were investigated for dengue-specific antibodies (IgM and IgG) and the nonstructural 1 antigen. The clinical findings of each subject were noted to assess the severity of the infection. Tests for hematological parameters were performed. Of 130 patients with confirmed dengue infection, 23 had severe and 107 had nonsevere dengue. Patients with severe dengue experienced mucosal bleeding (71.4%), fluid accumulation (57.1%), shock (35.7%), and gastrointestinal bleeding (28.6%). The most significant hematological findings among severe and nonsevere patients with dengue infection were thrombocytopenia, leukopenia, and a raised hematocrit level (P < 0.001). Patients with severe dengue infection showed marked thrombocytopenia, with a mean platelet count of 49.96 × 109 platelets/L. The clinical presentation of patients with dengue infection along with hematological markers are the most important clues for the diagnosis of, prognosis of, and therapy for dengue infection. Thrombocytopenia, leukopenia, and raised hematocrit levels were the most significant hematological parameters when assessing the severity of dengue infection.

Author Notes

Authors’ addresses: Faiz Ul Haq and Muhammad Imran, Department of Microbiology, University of Health Sciences, Lahore, Pakistan, E-mails: faizulhaq@uhs.edu.pk and mi.bannu@yahoo.com. Zeenaf Aslam, Institute of Nursing Sciences, Khyber Medical University, Peshawar, Pakistan, E-mail: zeenafaslam@uhs.edu.pk. Farhan Mukhtar, University College of Nursing, The Islamia University of Bahawalpur, Bahawalpur, Pakistan, E-mail: farhan.mukhtar@iub.edu.pk. Kokab Jabeen and Mahnoor Chaudhry, Department of Pathology, Ameer Ud Din Medical College, Lahore, Pakistan, E-mails: kaukab_jabeen@yahoo.com and mahnoorchaudhry474@gmail.com. Saeed Ur Rahman, Department of Nursing, University of Health Sciences, Lahore, Pakistan, E-mail: saeediann@gmail.com. Nasir Muhammad, Department of Hematology, University of Health Sciences, Lahore, Pakistan, E-mail: nasirhema@gmail.com.

Address correspondence to Faiz Ul Haq, Department of Microbiology, University of Health Sciences, Lahore, Punjab 54600, Pakistan. E-mail: faizulhaq@uhs.edu.pk
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