Clinical Infection in Practice (Oct 2020)
Diabetes mellitus as a prognostic factor for dengue severity: Retrospective study from Hospital for Tropical Diseases, Bangkok
Abstract
Objective: The study was conducted to determine whether or not diabetes mellitus is a prognostic factor for dengue severity among patients infected with dengue-virus infection and admitted to the Hospital for Tropical Diseases, Bangkok, between January 2010 and December 2016, and to study the relation between co-morbidities and dengue infection among these patients. Methods: This study is a retrospective case–control study. After approval by the Ethics Committee of the Faculty of Tropical Medicine, data were collected from the hospital medical records of adult patients with laboratory-confirmed dengue infection. Results: A total of 240 dengue patients with median age 55 (range 47–61) years and a case to control ratio of 1:2, were studied. All in diabetic group were type 2 diabetes patients. Similarity of gender was used as a matching criterion. The study showed a significant outcome, with more dengue hemorrhagic fever (DHF) cases in the diabetic group and more dengue fever (DF) patients in the non-diabetic group (p = 0.016). However, diabetes mellitus showed no significant association with dengue severity according to both WHO 1997 and 2009 guidelines (p = 0.109 and 0.187, respectively). Interestingly, age was seen to be significantly related to dengue severity in this study. Severe dengue cases were found among younger adults rather than the elderly (aOR = 0.89 with 95% CI of 0.79–0.98, p = 0.013) according to WHO 1997 grading. 3.75% of diabetic patients with dengue infection had no fever at admission (p = 0.013). The association of other co-morbidities (such as hypertension and renal diseases) with dengue severity was also not established in this study. Conclusion: Although more DHF cases were found in the diabetic patient group in our study, it did not prove that diabetes mellitus was a prognostic factor for dengue severity and had any effect on treatment outcome. Age-related differences in the severity of dengue infection were found. Nonetheless, if diabetic patients were contracted with dengue infection, monitoring of disease progress and timely intervention should be prioritized.
