PDF(Pubmed)
Abstract：
Background: Dengue fever (DF) is a mosquito-borne illness with substantial economic and societal impact. Understanding laboratory trends of hospitalized Dominican Republic (DR) pediatric patients could help develop screening procedures in low-resourced settings. We sought to describe laboratory findings over time in DR children with DF and DF severity from 2018 to 2020. Methods: Clinical information was obtained prospectively from recruited children with DF. Complete blood count (CBC) laboratory measures were assessed across Days 1-10 of fever. Participants were classified as DF-negative and DF-positive and grouped by severity. We assessed associations of DF severity with demographics, clinical characteristics, and peripheral blood studies. Using linear mixed-models, we assessed if hematologic values/trajectories differed by DF status/severity. Results: A total of 597 of 1101 with a DF clinical diagnosis were serologically evaluated, and 574 (471 DF-positive) met inclusion criteria. In DF, platelet count and hemoglobin were higher on earlier days of fever (p < = 0.0017). Eighty had severe DF. Severe DF risk was associated with thrombocytopenia, intraillness anemia, and leukocytosis, differing by fever day (p < = 0.001). Conclusions: In a pediatric hospitalized DR cohort, we found marked anemia in late stages of severe DF, unlike the typically seen hemoconcentration. These findings, paired with clinical symptom changes over time, may help guide risk-stratified screenings for resource-limited settings.
摘要：
背景：登革热（DF）是一种蚊媒疾病，具有重大的经济和社会影响。了解住院多米尼加共和国（DR）儿科患者的实验室趋势可能有助于在资源匮乏的环境中开发筛查程序。我们试图描述2018年至2020年DF和DF严重程度的DR儿童随时间的实验室发现。方法：前瞻性地从招募的DF患儿中获得临床信息。在发烧的第1-10天评估全血细胞计数(CBC)实验室测量。参与者分为DF阴性和DF阳性，并按严重程度分组。我们评估了DF严重程度与人口统计学的关联，临床特征,和外周血研究。使用线性混合模型，我们评估了血液学值/轨迹是否因DF状态/严重程度而异。结果：在1101个有DF临床诊断的患者中，共597个进行了血清学评估，574（471DF阳性）符合纳入标准。在DF中，在发热早期,血小板计数和血红蛋白较高(p<=0.0017).八十个有严重的DF。严重的DF风险与血小板减少症有关，病内贫血，和白细胞增多，不同的发烧日（p<=0.001）。结论：在儿科住院DR队列中，我们在严重DF的晚期发现了明显的贫血，与通常看到的血液浓缩不同。这些发现,伴随着临床症状随时间的变化，可能有助于指导资源有限环境的风险分层筛查。
