Comparison of Hematological and Biochemical Biomarkers for Predicting Dengue Severity in Children.

Abstract

Dengue remains a global health concern, especially in tropical regions like Indonesia. As of July 2024, there were 149,866 reported cases and 844 deaths, with children aged 0-14 years accounting for 63% of fatalities. Dengue presents a wide clinical spectrum, ranging from asymptomatic infection to Severe Dengue. Early detection of Severe Dengue still heavily relies on clinical warning signs, which are often unreliable. This study aimed to identify potential biomarkers to predict Dengue severity in children. An observational study using secondary data from medical records at RSSA Malang (2014-2022) was conducted, involving 304 pediatric patients (161 Severe Dengue, 143 Non-Severe Dengue). Patient characteristics such as gender, age, weight, nutritional status, and hospital stay duration showed no significant correlation with severity. However, significant differences were found in several biomarkers, notably SGOT, SGPT, ΔHb, PT, albumin, platelets, monocytes, and NLR. SGPT (AUC 0.894; OR 24.3) and SGOT (AUC 0.884; OR 16.148) emerged as the most predictive biomarkers. SGPT showed the highest diagnostic performance with 73% sensitivity, 90% specificity, and a cut-off value ≥52 µ/dL, indicating a 24.3-fold increased risk for Severe Dengue. SGPT may serve as a reliable early indicator of severity in pediatric Dengue cases.