Severe dengue in adults: Clinical features from the 2022 dengue outbreak at a Vietnamese tertiary hospital.

IF 3.4 2区医学 Q1 PARASITOLOGY

PLoS Neglected Tropical Diseases Pub Date : 2025-10-03 eCollection Date: 2025-10-01 DOI:10.1371/journal.pntd.0013589

Oanh Kim Pham, Thuy Bich Duong, Tho Vinh Phan, Trung Ngoc Truong, Duong Thi Hai Ha, Hao Van Nguyen, Vu Thi Minh Hien, Trinh Huu Khanh Dong, Nguyen Lam Vuong, Lam Minh Yen, Sophie Yacoub, Catherine Louise Thwaites, Dong Thi Hoai Tam

{"title":"Severe dengue in adults: Clinical features from the 2022 dengue outbreak at a Vietnamese tertiary hospital.","authors":"Oanh Kim Pham, Thuy Bich Duong, Tho Vinh Phan, Trung Ngoc Truong, Duong Thi Hai Ha, Hao Van Nguyen, Vu Thi Minh Hien, Trinh Huu Khanh Dong, Nguyen Lam Vuong, Lam Minh Yen, Sophie Yacoub, Catherine Louise Thwaites, Dong Thi Hoai Tam","doi":"10.1371/journal.pntd.0013589","DOIUrl":null,"url":null,"abstract":"Background: In Vietnam, dengue has been endemic for many years, with most cases reported in children. Recently, epidemiological data show an increasing frequency in adults, especially for severe dengue. An unprecedented post-COVID-19 surge resulted in an exceptionally high number of hospitalized dengue cases. We aim to describe the clinical phenotypes and outcomes in Vietnamese adults with severe dengue during the 2022 outbreak and explore host-related factors associated with disease variability and severity, through a retrospective study.Findings: A total of 891 cases were included, with mean age 29 ± 10 years. 284/891 (31.9%) patients had a BMI ≥ 25 kg/m2, and 240/891 (26.9%) had comorbidities. The predominant severe clinical phenotype was dengue shock syndrome (DSS): 737/891 (82.7%) patients. 107/891 (12%) DSS cases were associated with other severe manifestations. Severe hemorrhage accounted for 90/891 (10.1%) patients. Among cases with organ involvement (211/891 - 23.7%), hepatic impairment was observed in 196/891 (22%) patients, renal impairment 25/891 (2.8%), cardiac impairment 14/891 (1.6%) and neurological impairment 13/891 (1.5%). 250/737 (33.9%) DSS patients developing ≥ 1 episode of recurrent shock. They were younger than those without recurrent shock (25.3 vs 28.4 years, p = 0.007). Factors associated with recurrent shock episodes were: having BMI ≥ 25 (OR: 1.65; 95% CI: 1.18; 2.3), day of illness ≤ 5 (OR: 2.16; 95% CI: 1.51; 3.09) and prior COVID-19 infection (OR: 2.57; 95% CI: 1.62-4.06). Indicators for the \"associated severe phenotypes\" (DSS associated with severe hemorrhage, with organ impairment, or both) were older age (p = 0.018) and presence of comorbidities (p < 0.001) compared to the DSS alone phenotype. Overall, 98.1% of patients had a good recovery.Conclusions: Understanding the variability and complexity of severe dengue clinical manifestations, along with the different host factors associated with these features, will contribute to formulating suitable treatment guidelines for this at-risk population.","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 10","pages":"e0013589"},"PeriodicalIF":3.4000,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"PLoS Neglected Tropical Diseases","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1371/journal.pntd.0013589","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/10/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"PARASITOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: In Vietnam, dengue has been endemic for many years, with most cases reported in children. Recently, epidemiological data show an increasing frequency in adults, especially for severe dengue. An unprecedented post-COVID-19 surge resulted in an exceptionally high number of hospitalized dengue cases. We aim to describe the clinical phenotypes and outcomes in Vietnamese adults with severe dengue during the 2022 outbreak and explore host-related factors associated with disease variability and severity, through a retrospective study.

Findings: A total of 891 cases were included, with mean age 29 ± 10 years. 284/891 (31.9%) patients had a BMI ≥ 25 kg/m2, and 240/891 (26.9%) had comorbidities. The predominant severe clinical phenotype was dengue shock syndrome (DSS): 737/891 (82.7%) patients. 107/891 (12%) DSS cases were associated with other severe manifestations. Severe hemorrhage accounted for 90/891 (10.1%) patients. Among cases with organ involvement (211/891 - 23.7%), hepatic impairment was observed in 196/891 (22%) patients, renal impairment 25/891 (2.8%), cardiac impairment 14/891 (1.6%) and neurological impairment 13/891 (1.5%). 250/737 (33.9%) DSS patients developing ≥ 1 episode of recurrent shock. They were younger than those without recurrent shock (25.3 vs 28.4 years, p = 0.007). Factors associated with recurrent shock episodes were: having BMI ≥ 25 (OR: 1.65; 95% CI: 1.18; 2.3), day of illness ≤ 5 (OR: 2.16; 95% CI: 1.51; 3.09) and prior COVID-19 infection (OR: 2.57; 95% CI: 1.62-4.06). Indicators for the "associated severe phenotypes" (DSS associated with severe hemorrhage, with organ impairment, or both) were older age (p = 0.018) and presence of comorbidities (p < 0.001) compared to the DSS alone phenotype. Overall, 98.1% of patients had a good recovery.

Conclusions: Understanding the variability and complexity of severe dengue clinical manifestations, along with the different host factors associated with these features, will contribute to formulating suitable treatment guidelines for this at-risk population.

查看原文本刊更多论文

成人重症登革热：2022年越南某三级医院登革热暴发的临床特征

背景：在越南，登革热流行多年，大多数病例报告为儿童。最近，流行病学数据显示，成人，特别是重症登革热的发病率不断上升。covid -19后前所未有的激增导致住院登革热病例数量异常高。我们旨在通过一项回顾性研究，描述2022年爆发期间越南成年重症登革热患者的临床表型和结局，并探索与疾病变异性和严重程度相关的宿主相关因素。结果：共纳入891例，平均年龄29±10岁。284/891（31.9%）患者BMI≥25kg /m2, 240/891（26.9%）患者存在合并症。重症临床表型以登革休克综合征（DSS）为主：737/891例（82.7%）。891例DSS患者中有107例（12%）伴有其他严重症状。重度出血占90/891（10.1%）。在脏器受累（211/891 - 23.7%）的患者中，有196/891（22%）例出现肝功能损害，25/891（2.8%）例出现肾脏损害，14/891（1.6%）例出现心脏损害，13/891（1.5%）例出现神经功能损害。250/737 (33.9%) DSS患者发生≥1次复发性休克。他们比无复发性休克的患者年轻（25.3岁vs 28.4岁，p = 0.007）。与复发性休克发作相关的因素是：BMI≥25 （OR: 1.65; 95% CI: 1.18; 2.3）、发病天数≤5 （OR: 2.16; 95% CI: 1.51; 3.09）和既往感染COVID-19 （OR: 2.57; 95% CI: 1.62-4.06）。“相关严重表型”（DSS与严重出血、器官损害或两者相关）的指标是年龄较大（p = 0.018）和合并症的存在(p)。结论：了解严重登革热临床表现的变异性和复杂性，以及与这些特征相关的不同宿主因素，将有助于为这一高危人群制定合适的治疗指南。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

PLoS Neglected Tropical Diseases PARASITOLOGY-TROPICAL MEDICINE

自引率

10.50%

发文量

723

期刊介绍： PLOS Neglected Tropical Diseases publishes research devoted to the pathology, epidemiology, prevention, treatment and control of the neglected tropical diseases (NTDs), as well as relevant public policy. The NTDs are defined as a group of poverty-promoting chronic infectious diseases, which primarily occur in rural areas and poor urban areas of low-income and middle-income countries. Their impact on child health and development, pregnancy, and worker productivity, as well as their stigmatizing features limit economic stability. All aspects of these diseases are considered, including: Pathogenesis Clinical features Pharmacology and treatment Diagnosis Epidemiology Vector biology Vaccinology and prevention Demographic, ecological and social determinants Public health and policy aspects (including cost-effectiveness analyses).