Serum lipid profile: a predictor of clinical outcome in dengue infection.

OBJECTIVES: To correlate serum lipoproteins levels with dengue severity, clinical outcome (patient survival), bleeding severity, capillary leakage, supportive care requirement and hospital stay duration.
METHODS: Single centre, prospective study.
SETTING: Tertiary care hospital.
SUBJECTS: 50 (1 month-18 years) dengue fever cases and 50 age and sex matched non-febrile controls.
Methods: patients were classified (WHO criteria) as dengue fever (DF), dengue haemorrhagic fever (DHF), dengue shock syndrome (DSS). Bleeding score; serum triglyceride, cholesterol, HDL, LDL and VLDL was determined. Statistical analysis was done using Chi-squared test with continuity correction, Unpaired t-test, ANOVA with post hoc test, Binary logistic and multinomial regression.
RESULTS: 18 (36%) patients were DF, 19 (38%) DHF and 13 (26%) DSS. Lowest cholesterol, VLDL levels seen in DSS and highest in DF. Mean cholesterol level is significantly lower in expired patients and patients with third spacing. Severe bleeding significantly correlated with cholesterol level and hepatic dysfunction but not with platelet count or coagulopathy. Duration of intravenous fluid requirement and packed cell requirement negatively correlated with HDL and cholesterol levels. Fresh frozen plasma requirement negatively correlated with TG, HDL, VLDL and cholesterol levels. Platelet transfusion requirement and duration of hospital stay did not correlate with lipid levels. Intensive care and ventilator requirement negatively correlated with cholesterol level; inotrope requirement negatively correlated with HDL level. Ventilator requirement correlated negatively with TG levels also.
CONCLUSIONS: Lipid profile changes accompany dengue infection, some of which may indicate severity and guide therapy.