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

Nguyen Lam Vuong, Phung Khanh Lam, Damien Keng Yen Ming, Huynh Thi Le Duyen, Nguyet Minh Nguyen, Dong Thi Hoai Tam, Duong Thi Hue Kien, Nguyen Van Vinh Chau, Ngoun Chanpheaktra, Lucy Chai See Lum, Ernesto Pleités, Cameron P. Simmons, Kerstin D. Rosenberger, Thomas Jaenisch, David Bell, Nathalie Acestor, Christine Halleux, Piero L. Olliaro, Bridget A. Wills, Ronald B. GeskusSophie Yacoub

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    Abstract

    Background: Early identification of severe dengue patients is important regarding patient management and resource allocation. We investigated the association of ten 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.

    Original languageEnglish
    Article numbere67460
    Number of pages41
    JournaleLife
    Volume10
    DOIs
    Publication statusPublished - Jun 2021

    Keywords

    • Biomarkers
    • Dengue
    • IL1Ra
    • Prognostic
    • Syndecan

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