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Meta-Analysis
. 2023 Oct 14;13(1):17485.
doi: 10.1038/s41598-023-44559-9.

Early biomarkers for prediction of severe manifestations of dengue fever: a systematic review and a meta-analysis

Samaneh Moallemi  1   2 , Andrew R Lloyd  2 , Chaturaka Rodrigo  3   4
Affiliations
Meta-Analysis

Early biomarkers for prediction of severe manifestations of dengue fever: a systematic review and a meta-analysis

Samaneh Moallemi et al. Sci Rep. .

Abstract

Early identification of dengue patients at risk of adverse outcomes is important to prevent hospital overcrowding in low- to middle- income countries during epidemics. We performed a systematic review to identify which biomarkers measured in first 96 h of fever could predict dengue haemorrhagic fever (DHF, World Health Organization 1997 clinical classification) or severe dengue (SD, WHO 2009, clinical classification). PubMed, Scopus, CINAHL, Web of Science, and EMBASE databases were searched for prospective cohort and nested case-control studies published from 1997 to Feb 27, 2022. The protocol for the study was registered in PROSPERO (ID: CRD42021230053). After screening 6747 publications, and analysing 37 eligible studies reporting on 5925 patients, elevated C-reactive protein, aspartate aminotransferase, interleukin-8 and decreased albumin levels were strongly associated with dengue haemorrhagic fever (by meta-analyses of multiple studies, p < 0.05), while elevated vascular cell adhesion protein 1, syndecan-1, aspartate aminotransferase and C-reactive protein levels were strongly associated with severe dengue (by meta-analyses of multiple studies, p < 0.05). Further 44 and 28 biomarkers were associated with the risk of DHF and SD respectively, but only in a single study. The meta-analyses suggest the importance of early acute inflammation with hepatic involvement in determining the subsequent course of illness in dengue.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
PRISMA flow diagram of study selection.
Figure 2
Figure 2
Meta-analysis of biomarkers between patients with dengue haemorrhagic fever (DHF) and those with non-DHF dengue fever (DF)—(A) Fixed effect model, (B) random effect model.
Figure 2
Figure 2
Meta-analysis of biomarkers between patients with dengue haemorrhagic fever (DHF) and those with non-DHF dengue fever (DF)—(A) Fixed effect model, (B) random effect model.
Figure 3
Figure 3
Meta-analysis of biomarkers between patients with severe dengue (SD) and others with dengue fever (DF)—fixed effect model.
Figure 4
Figure 4
Meta-analysis of biomarkers between patients with severe disease (SD + DHF combined) and non-severe disease—(A) Fixed effect model, (B) random effect model.
Figure 4
Figure 4
Meta-analysis of biomarkers between patients with severe disease (SD + DHF combined) and non-severe disease—(A) Fixed effect model, (B) random effect model.
See this image and copyright information in PMC

References

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