Evaluación de pacientes con Dengue hemorrágico vs no hemorrágico en un hospital general de agudos

Abstract

Objectives: To analyze the clinical and laboratory characteristics of patients hospitalized with dengue infection in a general acute care hospital in Mendoza, Argentina.

Materials and Methods: This was a prospective, observational, and comparative study of patients diagnosed with autochthonous dengue admitted to the Internal Medicine Department, Hospital Luis Lagomaggiore, from March to April 2024. Dengue diagnosis was based on NS1 antigen, PCR, IgM, and epidemiological linkage. Warning signs (WS) and Severe Dengue (SD) were defined per ministerial guidelines. Two groups were compared: Dengue without hemorragic manifestations (DsH) and Dengue with hemorragic manifestations (DcH). Statistical analysis used χ2 or Student's t-test (p < 0.05).

Results: Of 68 patients, women 50 (73.5%), mean age 40.76 ± 17.6 years, with a hospital stay of 4 (2-6) days. NHD occurred in 36 (52.9%) and HD in 32 (47.1%). Bleeding sites included: genital 11 (34.4%), gastrointestinal and epistaxis 9 (28.1%). Serositis was noted in 4 (5.9%). At admission, hemoconcentration and thrombocytopenia 40 (58.8%), and hepatitis 15 (22.1%). WS were present in  54 (79.4%) and SD in  16 (23.5%) of patients.

Comparative analysis (Dsh vs. DcH) revealed: women 23 (63.9%) vs 27 (84.4%) p0.05, mean age 45.5 ± 20.3 years vs 35.4 ±12.5 years p0.01. They also showed: fever 29 (80.6%) vs 32 (100%) p0.008, headache 23 (63.9%) vs 27 (84.4%) p0.05, abdominal pain 11 (30.6%) vs 17 (53.1%) p0.05 and altered consciousness 7 (19.4%) vs 1 (3.1%) p0.03. Moreover, they presented WS SA 25 (69.4%) vs 29 (90.6%) p0.03 and SD (11.1%) vs 12 (37.5%) p0.01 

Conclusion: In our cohort, dengue was more common in middle-aged women, frequently associated with thrombocytopenia and hemoconcentration. DcH was more prevalent in younger women with fever, headache, abdominal pain, more warning signs, and severe dengue.