Narcisse Elenga1, Donald Celicourt2, Blandine Muanza3, Gisèle Elana4, Sévérine Hocquelet5, Vanessa Tarer6, Frédéric Maillard3, Gérard Sibille7, Lydia Divialle Doumdo8, Marie Petras8, Benoit Tressières9, Maryse Etienne-Julan10. 1. Service de Médecine et Chirurgie Pédiatrique, Centre Hospitalier de Cayenne, Centre de référence de la drépanocytose aux Antilles-Guyane, French Guiana; Centre de référence de la drépanocytose aux Antilles-Guyane, French Guiana. Electronic address: elengafr@yahoo.fr. 2. Service de Pédiatrie, Maison de la Mère et de l'Enfant, CHU de la Martinique, Centre de référence de la drépanocytose aux Antilles-Guyane, French Guiana; Centre de référence de la drépanocytose aux Antilles-Guyane, French Guiana. 3. Service de Pédiatrie, pôle Parents-Enfants, CHU de Pointe-à-Pitre/Abymes, Centre de référence de la drépanocytose aux Antilles-Guyane, French Guiana; Centre de référence de la drépanocytose aux Antilles-Guyane, French Guiana. 4. Service de Médecine et Chirurgie Pédiatrique, Centre Hospitalier de Cayenne, Centre de référence de la drépanocytose aux Antilles-Guyane, French Guiana; Service de Pédiatrie, pôle Parents-Enfants, CHU de Pointe-à-Pitre/Abymes, Centre de référence de la drépanocytose aux Antilles-Guyane, French Guiana. 5. Service de Pédiatrie, pôle Parents-Enfants, CHU de Pointe-à-Pitre/Abymes, Centre de référence de la drépanocytose aux Antilles-Guyane, French Guiana. 6. Centre de référence de la drépanocytose aux Antilles-Guyane, French Guiana. 7. Centre de référence de la drépanocytose aux Antilles-Guyane, French Guiana; Service de Pédiatrie, CH de la Basse-Terre, Centre de référence de la drépanocytose aux Antilles-Guyane, French Guiana. 8. Centre de référence de la drépanocytose aux Antilles-Guyane, French Guiana; Unité Transversale de la Drépanocytose, pôle Parents-Enfants, CHU de Pointe-à-Pitre/Abymes, Centre de référence de la drépanocytose aux Antilles-Guyane, French Guiana. 9. Centre d'Investigation Clinique Antilles-Guyane, Inserm CIC 1424, French Guiana. 10. Centre de référence de la drépanocytose aux Antilles-Guyane, French Guiana; Unité Transversale de la Drépanocytose, pôle Parents-Enfants, CHU de Pointe-à-Pitre/Abymes, Centre de référence de la drépanocytose aux Antilles-Guyane, French Guiana; UMR Inserm 1134/Université des Antilles-Guyane, French Guiana.
Abstract
BACKGROUND: To describe the characteristics of dengue in sickle cell children and try to identify risk factors of severity. METHODS: In this retrospective study, we describe the evolution according to genotype (SS or SC and controls) and severity. RESULTS AND CONCLUSIONS: From 2005 to 2013, 106 hospitalizations for dengue fever were recorded, 35 SS genotype, 35 SC and 36 without SCD or any other chronic disease. The clinical evolution was quite different. During hospitalization, SC patients were more likely to develop multiorgan failure (31.4% versus 25.7% for SS, and 0% for controls, p=0.001), or acute pulmonary complications than patients without SC sickle cell disease (14.3% versus 8.6% for SS, and 0% for controls, p=0.03). Level 3 analgesic treatment was more frequent in SC patients (22.9% versus 3% for SS, and 0% for controls, p<0.001). Patients with SC sickle cell disease had a higher proportion of severe forms of dengue (57.1% versus 37.1% for SS, and 0% for controls, p<0.001) than patients without SC sickle cell disease. Transfer in intensive care unit was required for most SC patients (22.9% versus 3% for SS, and 0% for controls, p=0.005).Fatal episodes were more frequent in SC patients than in patients without SC sickle cell disease (5 deaths versus 1 for SS and 0 for controls, p=0.02). Thirty-three patients (47.1%) were diagnosed as having severe dengue (13 SS and 20 SC). On univariate analysis, age >10 years, acute pulmonary complications, multiorgan failure, severe anemia requiring transfusion, use of antibiotic treatment, need for treatment with morphine, and longer hospital stay were statistically more frequent in severe dengue-associated cases. Multiple logistic regression analysis showed that HbSC genotype and acute pulmonary complications, were significantly associated with severe dengue. In the multivariate model, the area of the ROC curve was 0.831. Children with SC genotype, typically thought to have less severe disease, actually had a higher rate of severe dengue and death than those with SS genotype.
BACKGROUND: To describe the characteristics of dengue in sickle cell children and try to identify risk factors of severity. METHODS: In this retrospective study, we describe the evolution according to genotype (SS or SC and controls) and severity. RESULTS AND CONCLUSIONS: From 2005 to 2013, 106 hospitalizations for dengue fever were recorded, 35 SS genotype, 35 SC and 36 without SCD or any other chronic disease. The clinical evolution was quite different. During hospitalization, SC patients were more likely to develop multiorgan failure (31.4% versus 25.7% for SS, and 0% for controls, p=0.001), or acute pulmonary complications than patients without SC sickle cell disease (14.3% versus 8.6% for SS, and 0% for controls, p=0.03). Level 3 analgesic treatment was more frequent in SC patients (22.9% versus 3% for SS, and 0% for controls, p<0.001). Patients with SC sickle cell disease had a higher proportion of severe forms of dengue (57.1% versus 37.1% for SS, and 0% for controls, p<0.001) than patients without SC sickle cell disease. Transfer in intensive care unit was required for most SC patients (22.9% versus 3% for SS, and 0% for controls, p=0.005).Fatal episodes were more frequent in SC patients than in patients without SC sickle cell disease (5 deaths versus 1 for SS and 0 for controls, p=0.02). Thirty-three patients (47.1%) were diagnosed as having severe dengue (13 SS and 20 SC). On univariate analysis, age >10 years, acute pulmonary complications, multiorgan failure, severe anemia requiring transfusion, use of antibiotic treatment, need for treatment with morphine, and longer hospital stay were statistically more frequent in severe dengue-associated cases. Multiple logistic regression analysis showed that HbSC genotype and acute pulmonary complications, were significantly associated with severe dengue. In the multivariate model, the area of the ROC curve was 0.831. Children with SC genotype, typically thought to have less severe disease, actually had a higher rate of severe dengue and death than those with SS genotype.
Authors: Aileen May Lue; Michelle-Ann Elizabeth Hue Richards-Dawson; Georgiana Marie Gordon-Strachan; Syed Matthew Kodilinye; Jacqueline Anne Theresa Dunkley-Thompson; Tracia Dahlia James-Powell; Curtis Alphonso Pryce; Chadwic De'sean Mears; Joshua James Anzinger; Karen Webster-Kerr; Celia Dana Claire Christie Journal: Front Med (Lausanne) Date: 2022-06-21
Authors: Ashley N Bonheur; Sarah Thomas; Sara H Soshnick; Emily McGibbon; Alan P Dupuis; Rene Hull; Sally Slavinski; Paula E Del Rosso; Don Weiss; Danielle T Hunt; Megan E McCabe; Amy B Dean; Rebecca Folkerth; Anne M Laib; Susan J Wong Journal: BMC Infect Dis Date: 2021-08-04 Impact factor: 3.090