C-reactive protein as a potential biomarker for disease progression in dengue: a multi-country observational study
BioMed Central ; BMC Medicine, 2020
academicJournal
Zugriff:
Background: Dengue infection can cause a wide spectrum of clinical outcomes. The severe clinical manifestations occur sufficiently late in the disease course, during day 4–6 of illness, to allow a window of opportunity for risk stratification. Markers of inflammation may be useful biomarkers. We investigated the value of C-reactive protein (CRP) measured early on illness days 1–3 to predict dengue disease outcome and the difference in CRP levels between dengue and other febrile illnesses (OFI). Method: We performed a nested case-control study using the clinical data and samples collected from the IDAMS-consortium multi-country study. This was a prospective multi-center observational study that enrolled almost 8000 participants presenting with a dengue-like illness to outpatient facilities in 8 countries across Asia and Latin America. Predefined severity definitions of severe and intermediate dengue were used as the primary outcomes. A total of 281 cases with severe/intermediate dengue were compared to 836 uncomplicated dengue patients as controls (ratio 1:3), and also 394 patients with OFI. Results: In patients with confirmed dengue, median (interquartile range) of CRP level within the first 3 days was 30.2 mg/L (12.4–61.2 mg/L) (uncomplicated dengue, 28.6 (10.5–58.9); severe or intermediate dengue, 34.0 (17.4–71.8)). Higher CRP levels in the first 3 days of illness were associated with a higher risk of severe or intermediate outcome (OR 1.17, 95% CI 1.07–1.29), especially in children. Higher CRP levels, exceeding 30 mg/L, also associated with hospitalization (OR 1.37, 95% CI 1.14–1.64) and longer fever clearance time (HR 0.84, 95% CI 0.76–0.93), especially in adults. CRP levels in patients with dengue were higher than patients with potential viral infection but lower than patients with potential bacterial infection, resulting in a quadratic association between dengue diagnosis and CRP, with levels of approximately 30 mg/L associated with the highest risk of having dengue. CRP had a positive ...
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C-reactive protein as a potential biomarker for disease progression in dengue: a multi-country observational study
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Autor/in / Beteiligte Person: | Vuong, Nguyen Lam ; Le Duyen, Huynh Thi ; Lam, Phung Khanh ; Tam, Dong Thi Hoai ; Vinh Chau, Nguyen Van ; Van Kinh, Nguyen ; Chanpheaktra, Ngoun ; Lum, Lucy Chai See ; Pleités, Ernesto ; Jones, Nick Keith ; Simmons, Cameron Paul ; Rosenberger, Kerstin ; Jaenisch, Thomas ; Halleux, Christine ; Olliaro, Piero Luigi ; Wills, Bridget ; Yacoub, Sophie |
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Veröffentlichung: | BioMed Central ; BMC Medicine, 2020 |
Medientyp: | academicJournal |
DOI: | 10.17863/CAM.53398 |
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