Dengue infection has a variable clinical course that ranges from mild illness to potentially lethal hemorrhage and shock. A recent study by Nandwani and colleagues from the Superspecialty Pediatric Hospital and Postgraduate Teaching Institute, Noida, Uttar Pradesh, looked into the potential of some hematological parameters observed early in the course of illness to predict clinical outcomes.

This retrospective study assessed the records of children hospitalized for dengue from 2017 through 2019 at the institute. Investigators sought to evaluate the link between the hematological parameters observed during first evaluation and the clinical outcomes.

Data obtained from 613 patients, with age ranging from 26 days to 17 years, were analyzed. About 29.85% of the patients had fever with warning signs, while 8.97% were noted to have severe dengue. Lower levels of hemoglobin, platelet count, mean corpuscular volume, mean corpuscular hemoglobin concentration, and mean platelet volume, as well as higher total leukocyte count (TLC), hematocrit, and red cell distribution width were found to be variably associated with several clinical outcomes, such as length of hospital stay, development of complications, need for blood component transfusion, inotropic support, and death. A TLC value of ≥20,000/mL and an initial platelet count of ≤20,000/mL had a significant association with mortality, noted the investigators, the odds ratios (95% confidence interval) being 11.81 (4.21-33.80) and 5.53 (1.90-16.09), respectively.

It was concluded that early hematological parameters during dengue infection may have the potential to predict clinical outcomes in children. High TLC and low platelet initially can potentially predict fatal outcomes in the disease course.

Source: Nandwani S, Bhakhri BK, Singh N, et al. Early hematological parameters as predictors for outcomes in children with dengue in northern India: A retrospective analysis. Rev Soc Bras Med Trop. 2021 Jan 29;54:e05192020.