ArticleBMC infectious diseases2024
Are viral loads in the febrile phase a predictive factor of dengue disease severity?
Article in BMC infectious diseases, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Acute-Phase Dengue Antibody Profiles in Pediatric Patients: Influence on Viremia and Disease Manifestations.Viruses · 2026Article
- Low-density granulocytes and neutrophil extracellular traps in dengue, impacts of interferon alpha and cell-free DNA.Scientific reports · 2025Article
- Model-directed generation of artificial CRISPR-Cas13a guide RNA sequences improves nucleic acid detection.Nature biotechnology · 2025Article
- Emergence of Dengue Virus Serotypes 1 and 3 in Mahottari and Adjacent Areas of Southern Nepal.Pathogens (Basel, Switzerland) · 2025Article
- Facing the escalating burden of dengue: Challenges and perspectives.PLOS global public health · 2023Review
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11 authors.
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Abstract
backgroundAs many studies have shown conflicting results regarding the extent of viraemia and clinical disease severity, we sought to investigate if viraemia during early dengue illness is associated with subsequent clinical disease severity.
methodsRealtime PCR was carried out to identify the dengue virus (DENV serotype), in 362 patients, presenting within the first 4 days of illness, from 2017 to 2022, in Colombo Sri Lanka. To characterize subsequent clinical disease severity, all patients were followed throughout their illness daily and disease severity classified according to WHO 1997 and 2009 disease classification.
results263 patients had DF, 99 progressed to develop DHF, and 15/99 with DHF developed shock (DSS). Although the viral loads were higher in the febrile phase in patients who progressed to develop DHF than in patients with DF this was not significant (p = 0.5). Significant differences were observed in viral loads in patients infected with different DENV serotypes (p = 0.0009), with lowest viral loads detected in DENV2 and the highest viral loads in DENV3. Sub-analysis for association of viraemia with disease severity for each DENV serotype was again not significant. Although those infected with DENV2 had lower viral loads, infection with DENV2 was significantly associated with a higher risk of developing DHF (p = 0.011, Odds ratio 1.9; 95% CI 1.164 to 3.078). Based on the WHO 2009 disease classification, 233 had dengue with warning signs (DWW), 114 dengue without warning signs (DWoWS), and 15 had severe dengue (SD). No significant difference was observed in the viral loads between those with SD, DWW and DWoWS (p = 0.27).
conclusionsViral loads were significantly different in the febrile phase between different DENV serotypes, and do not appear to significantly associate with subsequent clinical disease severity in a large Sri Lankan cohort.
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