Combination of inflammatory and vascular markers in the febrile phase of dengue is associated with more severe outcomes

Document Type

Article

Publication Date

6-22-2021

Abstract

Background: Early identification of severe dengue patients is important regarding patient management and resource allocation. We investigated the association of 10 biomarkers (VCAM-1, SDC-1, Ang-2, IL-8, IP-10, IL-1RA, sCD163, sTREM-1, ferritin, CRP) with the development of severe/ moderate dengue (S/MD). Methods: We performed a nested case-control study from a multi-country study. A total of 281 S/ MD and 556 uncomplicated dengue cases were included. Results: On days 1-3 from symptom onset, higher levels of any biomarker increased the risk of developing S/MD. When assessing together, SDC-1 and IL-1RA were stable, while IP-10 changed the association from positive to negative; others showed weaker associations. The best combinations associated with S/MD comprised IL-1RA, Ang-2, IL-8, ferritin, IP-10, and SDC-1 for children, and SDC-1, IL-8, ferritin, sTREM-1, IL-1RA, IP-10, and sCD163 for adults. Conclusions: Our findings assist the development of biomarker panels for clinical use and could improve triage and risk prediction in dengue patients.

Keywords

This study was supported by the EU's Seventh Framework Programme (FP7-281803, IDAMS), The WHO, And the Bill and Melinda Gates Foundation

Divisions

fac_med

Funders

European Commission[FP7-281803 IDAMS],World Health Organization UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases,Bill and Melinda Gates Foundation The Global Good Fund I, LLC at Intellectual Ventures

Publication Title

eLife

Volume

10

Publisher

eLife Sciences Publications

Publisher Location

SHERATON HOUSE, CASTLE PARK, CAMBRIDGE, CB3 0AX, ENGLAND

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