Risk factors and clinical outcome of profound thrombocytopenia in adult patients with DENV infections

Severe thrombocytopenia is common in dengue virus (DENV) infections. However, studies focusing on the role of profound thrombocytopenia (PT) (nadir platelet counts ≤ 20 000/mm³) in DENV infections are scarce. This study aims to identify the associated features and outcome of DENV patients with PT. It involves 237 adult hospitalized patients who were DENV PCR positive. The presence of comorbidity (AOR = 4.625; 95% CI = 1.113–19.230), higher admission hematocrit (AOR = 1.213; 95% CI = 1.067–1.379), lower admission albumin (AOR = 0.870; 95% CI = 0.766–0.988) and lower admission platelets (AOR = 0.980; 95% CI = 0.969–0.991) was associated with platelets ≤ 20 000/mm³ in multivariate logistic regression. PT was not affected by DENV serotypes, coinfections and secondary DENV infections. Patients with PT had significantly higher risk of experiencing warning signs (AOR = 3.709, 95% CI = 1.089–12.634) and longer hospital stay (AOR = 1.943, 95% CI = 1.010–3.774). However, severe dengue disease, hemorrhagic manifestations and need for intensive care were not significantly associated with PT.