Triple positivity for nonstructural antigen 1, immunoglobulin M and immunoglobulin G is predictive of severe thrombocytopaenia related to dengue infection.
J Clin Virol
; 129: 104509, 2020 08.
Article
em En
| MEDLINE
| ID: mdl-32554305
ABSTRACT
BACKGROUND:
The early identification of patients at risk of severe dengue infection (DI) is critical to guide clinical management. Non-structural antigen 1 (NS-1), immunoglobulin M (IgM) and immunoglobulin G (IgG) are used routinely for the diagnosis of DI.OBJECTIVES:
We sought to evaluate whether positivity for NS-1, IgM and IgG individually or together is predictive of severe complications of DI. METHODS & MATERIALS A prospective study was conducted among patients with DI admitted to our institution between 2014 and 2019. DI was diagnosed based on a positive NS1 or IgM. IgG was also tested on all the patients. Clinical data was obtained from electronic medical records at NH. Statistical analyses were performed using SPSS version 20.RESULTS:
We collected data on 3504 patients. Patients who were positive for NS1, IgM and IgG (triple positive TP) were more likely to develop severe DI (63.8 %) in comparison to those who were only NS1 positive (single positive SP) (3.0 %) and patients with positive NS1 and IgM (double positive DP) (7.5 %). [p = 0.001]. Regression analysis confirmed that TP status on admission was predictive of severe complications. (p < 0.01). Receiver operator characteristic curve (ROC) analysis showed (AUC 84.8; sensitivity = 90.7 and specificity = 83.2) that TP status on admission is predictive of thrombocytopenia on day 5. The predictive power of TP status was superior to that of NS1 and IgG positivity.CONCLUSIONS:
We propose that TP status on admission is a novel predictive factor for severe DI. Further studies are required to explore the biological basis for this finding.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Trombocitopenia
/
Dengue
/
Vírus da Dengue
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
J Clin Virol
Assunto da revista:
VIROLOGIA
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Singapura