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

• DOI: 10.7554/elife.67460
• Publication Date: 2021-06-22T00:00:28Z
• Authors: Nguyen Lam Vuong; Phung Khanh Lam; Damien Keng Yen Ming; Huynh Thi Le Duyen; Nguyet Minh Nguyen; Dong Thi Hoai Tam; Kien Duong Thi Hue; Nguyen VV Chau; Ngoun Chanpheaktra; Lucy Chai See Lum; Ernesto Pleités; Cameron P Simmons; Kerstin D Rosenbe...; Thomas Jaenisch; David Bell; Nathalie Acestor; Christine Halleux; Piero L Olliaro; Bridget A Wills; Ronald B Geskus; Sophie Yacoub
• Keywords: 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

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.