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

Life Sciences & Biomedicine - Other Topics IDAMS) SELECTION Adult Male 0301 basic medicine medicine Adolescent PREDICTION QH301-705.5 infectious disease Science 610 PROGRESSION virus 0601 Biochemistry and Cell Biology DISEASE Dengue Young Adult 03 medical and health sciences 616 Humans Biology (General) Preschool Child Biology Inflammation 0303 health sciences Science & Technology and the Bill and Melinda Gates Foundation microbiology Q R biomarkers SERUM-LEVELS dengue BIOMARKER PANEL 3. Good health HEMORRHAGIC-FEVER This study was supported by the EU's Seventh Framework Programme (FP7-281803 Case-Control Studies Child, Preschool Medicine Cytokines Female the WHO Life Sciences & Biomedicine prognostic Biomarkers
DOI: 10.7554/elife.67460 Publication Date: 2021-06-22T00:00:28Z
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.Funding:This study was supported by the EU's Seventh Framework Programme (FP7-281803 IDAMS), the WHO, and the Bill and Melinda Gates Foundation.
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