ArticlePLoS neglected tropical diseases2015
Lower Low-Density Lipoprotein Cholesterol Levels Are Associated with Severe Dengue Outcome.
Article in PLoS neglected tropical diseases, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 4 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
32 citing papers in PubMed, 4 syntheses or guidelines pooled it, 75 citations in OpenAlex.
- Early biomarkers for prediction of severe manifestations of dengue fever: a systematic review and a meta-analysis.Scientific reports · 2023Pooled it
- Association of Lipid Levels With COVID-19 Infection, Disease Severity and Mortality: A Systematic Review and Meta-Analysis.Frontiers in cardiovascular medicine · 2022Pooled it
- Plasma leakage in dengue: a systematic review of prospective observational studies.BMC infectious diseases · 2021Pooled it
- Predictive markers for the early prognosis of dengue severity: A systematic review and meta-analysis.PLoS neglected tropical diseases · 2021Pooled it
- Dengue virus and lipid metabolism: unravelling the interplay for future therapeutic approaches.Emerging microbes & infections · 2025Review
- The importance of paying attention to the role of lipid-lowering drugs in controlling dengue virus infection.Virology journal · 2024Review
- The Low-Density Lipoprotein Receptor-Related Protein-1 Is Essential for Dengue Virus Infection.Viruses · 2024Article
- A Holistic Approach to Cardiometabolic and Infectious Health in the General Population of Reunion Island: The REUNION Study.Journal of epidemiology and global health · 2024Article
- Direct mosquito feedings on dengue-2 virus-infected people reveal dynamics of human infectiousness.PLoS neglected tropical diseases · 2023Article
- The dengue virus NS1 protein; new roles in pathogenesis due to similarities with and affinity for the high-density lipoprotein (HDL)?PLoS pathogens · 2023Article
- Severe dengue in children associates with dysregulation of lipid homeostasis, complement cascade and retinol transport.Clinical and translational medicine · 2023Article
- Flying under the radar - impact and factors influencing asymptomatic DENV infections.Frontiers in cellular and infection microbiology · 2023Review
- Chronic depletion of vertebrate lipids in Aedes aegypti cells dysregulates lipid metabolism and inhibits innate immunity without altering dengue infectivity.PLoS neglected tropical diseases · 2022Article
- The Influence of SARS-CoV-2 Infection on Lipid Metabolism-The Potential Use of Lipid-Lowering Agents in COVID-19 Management.Biomedicines · 2022Review
- Dengue virus NS1 protein conveys pro-inflammatory signals by docking onto high-density lipoproteins.EMBO reports · 2022Article
- ApoA1 Neutralizes Proinflammatory Effects of Dengue Virus NS1 Protein and Modulates Viral Immune Evasion.Journal of virology · 2021Article
- Expression of Nitric Oxide Synthase and Nitric Oxide Levels in Peripheral Blood Cells and Oxidized Low-Density Lipoprotein Levels in Saliva as Early Markers of Severe Dengue.BioMed research international · 2021Article
- Anti-flavivirus Properties of Lipid-Lowering Drugs.Frontiers in physiology · 2021Review
- Review
- Dengue virus induces PCSK9 expression to alter antiviral responses and disease outcomes.The Journal of clinical investigation · 2020Article
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
Abstract
Dengue virus (DENV) is a flavivirus of worldwide importance, with approximately 4 billion people across 128 countries at risk of infection, and up to 390 million infections and 96 million clinically apparent cases estimated annually. Previous in vitro studies have shown that lipids and lipoproteins play a role in modifying virus infectivity. However, the relationship between development of severe dengue and total cholesterol, high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C), respectively, is unclear. We analyzed data from 789 laboratory-confirmed dengue cases and 447 other febrile illnesses (OFI) in a prospective pediatric hospital-based study in Managua, Nicaragua between August 2005 and January 2013, using three different classifications of dengue severity: World Health Organization (WHO) 1997, WHO 2009, and standardized intervention categories. Total serum cholesterol and LDL-C levels decreased over the course of illness and were generally lower with increasing dengue severity, regardless of classification scheme. Greater decreases in LDL-C than HDL-C were observed among dengue-positive patients compared to patients with OFI and among severe dengue compared to mild dengue cases. Furthermore, daily cholesterol levels declined with daily albumin blood levels. To examine the effect of cholesterol at presentation on subsequent risk of development of severe dengue, relative risks and 95% confidence intervals were calculated using multivariable modified Poisson models. We found that lower total serum cholesterol and LDL-C levels at presentation were associated with subsequent risk of developing dengue hemorrhagic fever/dengue shock syndrome using the WHO 1997 dengue severity classification, and thus that the reduction in LDL-C is likely driving the decreases observed in total serum cholesterol levels among dengue-positive patients. Our results suggest that cholesterol blood levels are important correlates of dengue pathophysiology and should be explored as part of a prognostic biomarker panel for severe dengue.
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