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Nguyen Lam Vuong, Sophie Yacoub & colleagues have identified a combination of biological markers in patients with dengue that could predict whether they go on to develop moderate to severe disease. Biomarkers are used to identify the state or risk of a disease in patients; these findings could aid the development of biomarker panels for clinical use and help improve triage and risk prediction in patients with dengue.

Gloved hand holding two blood samples in test tubes

“While most symptomatic dengue infections are self-limiting, a small number of patients develop complications that usually occur at around four to six days from symptom onset,” explains first author Vuong Nguyen Lam, Researcher and PHD Student at OUCRU, Ho Chi Minh City, Vietnam. “Large numbers of patients therefore need regular assessments to identify these complications. The accurate and early identification of such patients, particularly within the first three days of illness, should allow for the appropriate care to be provided.”

To address this, Vuong and colleagues selected 10 candidate biomarkers from vascular, immunological and inflammatory pathways that are associated with dengue disease pathogenesis. They analysed 281 cases in four countries – Vietnam, Cambodia, Malaysia and El Salvador – and found that, during the first three days of illness, higher levels of any of the 10 biomarkers increased a patient’s risk of developing moderate to severe dengue.

They also identified a combination of six biomarkers that was best associated with severe disease in children, and a combination of seven biomarkers that was best associated with severe disease in adults. “This highlights how relationships between biomarkers and clinical outcome can differ between age groups,” Vuong says.

“Together, our findings should assist the development of biomarker panels to help improve future triage and early assessment of dengue patients,” concludes senior author Sophie Yacoub, Dengue Research Group Head at OUCRU. “This would help improve individual patient management and healthcare allocation, which would be of major public health benefit especially in outbreak settings.”

The full press release is available on the eLife website

Read the publications: Combination of inflammatory and vascular markers in the febrile phase of dengue is associated with more severe outcomes

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