Predictive markers for the early prognosis of dengue severity: A systematic review and meta-analysis.

<h4>Background</h4>Predictive markers represent a solution for the proactive management of severe dengue. Despite the low mortality rate resulting from severe cases, dengue requires constant examination and round-the-clock nursing care due to the unpredictable progression of complication...

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Autores principales:	Tran Quang Thach, Heba Gamal Eisa, AlMotsim Ben Hmeda, Hazem Faraj, Tieu Minh Thuan, Manal Mahmoud Abdelrahman, Mario Gerges Awadallah, Nam Xuan Ha, Michael Noeske, Jeza Muhamad Abdul Aziz, Nguyen Hai Nam, Mohamed El Nile, Shyam Prakash Dumre, Nguyen Tien Huy, Kenji Hirayama
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/659fe09ce6fb4647a477f53178a8aa6d
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spelling	oai:doaj.org-article:659fe09ce6fb4647a477f53178a8aa6d2021-11-25T06:31:43ZPredictive markers for the early prognosis of dengue severity: A systematic review and meta-analysis.1935-27271935-273510.1371/journal.pntd.0009808https://doaj.org/article/659fe09ce6fb4647a477f53178a8aa6d2021-10-01T00:00:00Zhttps://doi.org/10.1371/journal.pntd.0009808https://doaj.org/toc/1935-2727https://doaj.org/toc/1935-2735<h4>Background</h4>Predictive markers represent a solution for the proactive management of severe dengue. Despite the low mortality rate resulting from severe cases, dengue requires constant examination and round-the-clock nursing care due to the unpredictable progression of complications, posing a burden on clinical triage and material resources. Accordingly, identifying markers that allow for predicting disease prognosis from the initial diagnosis is needed. Given the improved pathogenesis understanding, myriad candidates have been proposed to be associated with severe dengue progression. Thus, we aim to review the relationship between the available biomarkers and severe dengue.<h4>Methodology</h4>We performed a systematic review and meta-analysis to compare the differences in host data collected within 72 hours of fever onset amongst the different disease severity levels. We searched nine bibliographic databases without restrictive criteria of language and publication date. We assessed risk of bias and graded robustness of evidence using NHLBI quality assessments and GRADE, respectively. This study protocol is registered in PROSPERO (CRD42018104495).<h4>Principal findings</h4>Of 4000 records found, 40 studies for qualitative synthesis, 19 for meta-analysis. We identified 108 host and viral markers collected within 72 hours of fever onset from 6160 laboratory-confirmed dengue cases, including hematopoietic parameters, biochemical substances, clinical symptoms, immune mediators, viral particles, and host genes. Overall, inconsistent case classifications explained substantial heterogeneity, and meta-analyses lacked statistical power. Still, moderate-certainty evidence indicated significantly lower platelet counts (SMD -0.65, 95% CI -0.97 to -0.32) and higher AST levels (SMD 0.87, 95% CI 0.36 to 1.38) in severe cases when compared to non-severe dengue during this time window.<h4>Conclusion</h4>The findings suggest that alterations of platelet count and AST level-in the first 72 hours of fever onset-are independent markers predicting the development of severe dengue.Tran Quang ThachHeba Gamal EisaAlMotsim Ben HmedaHazem FarajTieu Minh ThuanManal Mahmoud AbdelrahmanMario Gerges AwadallahNam Xuan HaMichael NoeskeJeza Muhamad Abdul AzizNguyen Hai NamMohamed El NileShyam Prakash DumreNguyen Tien HuyKenji HirayamaPublic Library of Science (PLoS)articleArctic medicine. Tropical medicineRC955-962Public aspects of medicineRA1-1270ENPLoS Neglected Tropical Diseases, Vol 15, Iss 10, p e0009808 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
spellingShingle	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Tran Quang Thach Heba Gamal Eisa AlMotsim Ben Hmeda Hazem Faraj Tieu Minh Thuan Manal Mahmoud Abdelrahman Mario Gerges Awadallah Nam Xuan Ha Michael Noeske Jeza Muhamad Abdul Aziz Nguyen Hai Nam Mohamed El Nile Shyam Prakash Dumre Nguyen Tien Huy Kenji Hirayama Predictive markers for the early prognosis of dengue severity: A systematic review and meta-analysis.
description	<h4>Background</h4>Predictive markers represent a solution for the proactive management of severe dengue. Despite the low mortality rate resulting from severe cases, dengue requires constant examination and round-the-clock nursing care due to the unpredictable progression of complications, posing a burden on clinical triage and material resources. Accordingly, identifying markers that allow for predicting disease prognosis from the initial diagnosis is needed. Given the improved pathogenesis understanding, myriad candidates have been proposed to be associated with severe dengue progression. Thus, we aim to review the relationship between the available biomarkers and severe dengue.<h4>Methodology</h4>We performed a systematic review and meta-analysis to compare the differences in host data collected within 72 hours of fever onset amongst the different disease severity levels. We searched nine bibliographic databases without restrictive criteria of language and publication date. We assessed risk of bias and graded robustness of evidence using NHLBI quality assessments and GRADE, respectively. This study protocol is registered in PROSPERO (CRD42018104495).<h4>Principal findings</h4>Of 4000 records found, 40 studies for qualitative synthesis, 19 for meta-analysis. We identified 108 host and viral markers collected within 72 hours of fever onset from 6160 laboratory-confirmed dengue cases, including hematopoietic parameters, biochemical substances, clinical symptoms, immune mediators, viral particles, and host genes. Overall, inconsistent case classifications explained substantial heterogeneity, and meta-analyses lacked statistical power. Still, moderate-certainty evidence indicated significantly lower platelet counts (SMD -0.65, 95% CI -0.97 to -0.32) and higher AST levels (SMD 0.87, 95% CI 0.36 to 1.38) in severe cases when compared to non-severe dengue during this time window.<h4>Conclusion</h4>The findings suggest that alterations of platelet count and AST level-in the first 72 hours of fever onset-are independent markers predicting the development of severe dengue.
format	article
author	Tran Quang Thach Heba Gamal Eisa AlMotsim Ben Hmeda Hazem Faraj Tieu Minh Thuan Manal Mahmoud Abdelrahman Mario Gerges Awadallah Nam Xuan Ha Michael Noeske Jeza Muhamad Abdul Aziz Nguyen Hai Nam Mohamed El Nile Shyam Prakash Dumre Nguyen Tien Huy Kenji Hirayama
author_facet	Tran Quang Thach Heba Gamal Eisa AlMotsim Ben Hmeda Hazem Faraj Tieu Minh Thuan Manal Mahmoud Abdelrahman Mario Gerges Awadallah Nam Xuan Ha Michael Noeske Jeza Muhamad Abdul Aziz Nguyen Hai Nam Mohamed El Nile Shyam Prakash Dumre Nguyen Tien Huy Kenji Hirayama
author_sort	Tran Quang Thach
title	Predictive markers for the early prognosis of dengue severity: A systematic review and meta-analysis.
title_short	Predictive markers for the early prognosis of dengue severity: A systematic review and meta-analysis.
title_full	Predictive markers for the early prognosis of dengue severity: A systematic review and meta-analysis.
title_fullStr	Predictive markers for the early prognosis of dengue severity: A systematic review and meta-analysis.
title_full_unstemmed	Predictive markers for the early prognosis of dengue severity: A systematic review and meta-analysis.
title_sort	predictive markers for the early prognosis of dengue severity: a systematic review and meta-analysis.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/659fe09ce6fb4647a477f53178a8aa6d
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Predictive markers for the early prognosis of dengue severity: A systematic review and meta-analysis.

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