Evidence map›Paper›PMID 34627388›Full record

SynthesisInfectious diseases of poverty2021

Clinical predictors of severe dengue: a systematic review and meta-analysis.

Tsheten Tsheten, Archie C A Clements, Darren J Gray, Ripon K Adhikary, Luis Furuya-Kanamori, Kinley Wangdi

Registry-linked trialOpen access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Infectious diseases of poverty, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06697041 (Clinical and Laboratory Factors for the Progression of Severe Dengue Among Hospitalized Patients During an Upsurge), which is not on this map. Cited by 78 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
78citing papers in PubMed, 4 pooled it
17.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

NCT06697041 completednot on this mapstarted 2024, after this paper: background citation

Clinical and Laboratory Factors for the Progression of Severe Dengue Among Hospitalized Patients During an Upsurge

TypeobservationalSponsorInternational Centre for Diarrhoeal Disease Research, BangladeshRan2024 to 2024Enrolled324ConditionsDengue Fever With Warning Signs
3 · Its place in the literature

Who cites it

78 citing papers in PubMed, 4 syntheses or guidelines pooled it, 156 citations in OpenAlex.

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  15. Dengue Dilemma: Navigating Cross-Reactivity and Immune Challenges.Current topics in microbiology and immunology · 2026
    Review
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18 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 2 countries.

Tsheten TshetenDepartment of Global Health, Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, Australia. tsheten.tsheten@anu.edu.au.ORCID http://orcid.org/0000-0002-8071-5721
Archie C A ClementsTelethon Kids Institute, Nedlands, Australia.
Darren J GrayDepartment of Global Health, Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, Australia.
Ripon K AdhikaryDepartment of Global Health, Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, Australia.
Luis Furuya-Kanamori *UQ Centre for Clinical Research, The University of Queensland, Herston, QLD, Australia.
Kinley Wangdi *Department of Global Health, Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, Australia.
Australian National University · AUThe Kids Research Institute Australia · AUThe University of Queensland · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSevere dengue is a life-threatening complication; rapid identification of these cases, followed by adequate management is crucial to improve the clinical prognosis. Therefore, this study aimed to identify risk factors and predictors of severe dengue.

methodsA literature search for studies reporting risk factors of severe dengue among individuals with dengue virus infection was conducted in PubMed, Scopus and Web of Science database from inception to December 31, 2020. Pooled odds ratios (ORs) for patients' demographic characteristics, co-morbidities, and warning signs were estimated using an inverse variance heterogeneity model.

resultsWe included 143 articles in the meta-analysis from a total of 13 090 articles retrieved from the literature search. The risk factors of severe dengue were: being a child [OR = 1.96; 95% confidence interval (CI): 1.22-3.13], secondary infection (OR = 3.23; 95% CI: 2.28-4.57), and patients with pre-existing diabetes (OR = 2.88; 95% CI: 1.72-4.81) and renal disease (OR = 4.54; 95% CI: 1.55-13.31). Warning signs strongly associated with severe disease were increased haematocrit with a concurrent decrease in platelet count (OR = 5.13; 95% CI: 1.61-16.34), abdominal pain (OR = 2.00; 95% CI: 1.49-2.68), lethargy (OR = 2.73; 95% CI: 1.05-7.10), vomiting (OR = 1.80; 95% CI: 1.43-2.26), hepatomegaly (OR = 5.92; 95% CI: 3.29-10.66), ascites (OR = 6.30; 95% CI: 3.75-10.60), pleural effusion (OR = 5.72; 95% CI: 3.24-10.10) and melena (OR = 4.05; 95% CI: 1.64-10.00).

conclusionsOur meta-analysis identified children, secondary infection, diabetes and renal disease(s) as important predictors of severe dengue. Our finding also supports the predictive ability of the WHO warning signs to identify severe dengue. These findings are useful for clinicians to identify severe dengue for management and timely interventions.

Indexed as

Severe DengueHumansRisk FactorsMeta-analysisRisk factorSevere dengueWarning sign

Identifiers

PMID34627388
PMCPMC8501593
OpenAlexW3207679345

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.