eLife (Jun 2021)

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

  • 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 Rosenberger,
  • Thomas Jaenisch,
  • David Bell,
  • Nathalie Acestor,
  • Christine Halleux,
  • Piero L Olliaro,
  • Bridget A Wills,
  • Ronald B Geskus,
  • Sophie Yacoub

DOI
https://doi.org/10.7554/eLife.67460
Journal volume & issue
Vol. 10

Abstract

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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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