Evidence map›Paper›PMID 40247229›Full record

Observational studyBMC infectious diseases2025

Low atypical lymphocyte score as a predictor of non-severe dengue.

Chandramathi Samudi Raju, Mari Kono, Kah Wai Looi, Jin Xu Ong, Chin Aun Tan, Chong Siang Ang, Peter Hao Yuan Tan, Hemalatha Shamnugam, Shamala Devi K C Sekaran, Sharifah Faridah Syed Omar and 1 more

Abstract readObservational Study
In one paragraph

Observational study in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

11 authors.

Chandramathi Samudi RajuFaculty of Medicine, Universiti Malaya, Wilayah Persekutuan, 50603, Kuala Lumpur, Malaysia.
Mari KonoR&D Centre Asia Pacific, Sysmex Asia Pacific, 9 Tampines Grande, Asia Green, #06-18, Singapore.
Kah Wai LooiUniversiti Malaya Medical Center, Lembah Pantai, 59100, Kuala Lumpur, Malaysia.
Jin Xu OngUniversiti Malaya Medical Center, Lembah Pantai, 59100, Kuala Lumpur, Malaysia.
Chin Aun TanUniversiti Malaya Medical Center, Lembah Pantai, 59100, Kuala Lumpur, Malaysia.
Chong Siang AngUniversiti Malaya Medical Center, Lembah Pantai, 59100, Kuala Lumpur, Malaysia.
Peter Hao Yuan TanUniversiti Malaya Medical Center, Lembah Pantai, 59100, Kuala Lumpur, Malaysia.
Hemalatha ShamnugamFaculty of Medicine, Universiti Malaya, Wilayah Persekutuan, 50603, Kuala Lumpur, Malaysia.
Shamala Devi K C SekaranFaculty of Applied Sciences, UCSI University, Wilayah Persekutuan, 56000, Kuala Lumpur, Malaysia.
Sharifah Faridah Syed OmarFaculty of Medicine, Universiti Malaya, Wilayah Persekutuan, 50603, Kuala Lumpur, Malaysia.
Lucy Chai See LumFaculty of Medicine, Universiti Malaya, Wilayah Persekutuan, 50603, Kuala Lumpur, Malaysia. lumcs@ummc.edu.my.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSevere dengue has been linked to the presence of atypical lymphocytes, which can be quantified using the Q-flag parameter on a hematology analyzer. A higher atypical lymphocyte count has previously been associated with severe dengue. We aimed to evaluate the feasibility of the atypical lymphocyte score to provide an early prognosis for dengue severity.

methodA prospective observational study enrolled adult patients admitted to the Infectious Disease ward with a febrile illness of less than 7 days. Blood samples obtained daily until discharge, were processed with XN-20 hematology analyzer with specific attention given to atypical lymphocyte score. Severe dengue cases were classified according to the 2009 World Health Organization Classification.

resultsA total of 287 cases of laboratory-confirmed dengue, including 25 severe cases, were included. Dengue fever compared to non-dengue patients manifested increased lymphocytes within the high fluorescent zone on Day 6, The atypical lymphocyte score (ALS) of severe dengue showed an early rise, reaching a saturation point of 300 and remaining stable within the timeframe of days 4 to 8 post-fever onset. All but one severe dengue patient had a score exceeding 100 on day 4 post fever onset.

conclusionAn atypical lymphocyte score below 100 on day 4 post fever onset, may serve as a predictive indicator that severe dengue is less likely to develop, potentially allowing for a lower level of medical intervention. These findings may contribute to more efficient resource allocation during outbreaks.

trial registrationThe study was registered under National Medical Research Registration of Malaysia, (NMRR-18-3347-45473, 1 Sept 2019).

Indexed as

DengueLymphocytesAdolescentAdultAgedFemaleHumansLymphocyte CountMaleMiddle AgedPrognosisProspective StudiesSeverity of Illness IndexYoung AdultAtypical lymphocyteBiomarkerDengueHematology analyzerPrognosisRisk stratification

Identifiers

PMID40247229
PMCPMC12007337

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.