Neurologic complications in dengue virus infection: a prospective cohort study.

Neurology

From the Departments of Neurology (R.S., R.V., R.K.G., M.K.S., H.S.M., P.K.S.), Microbiology (A.J.), and Radiodiagnosis (A.P.), King George's Medical University, Lucknow, India.

Published: October 2014

AI Article Synopsis

  • The study assessed the frequency and types of neurologic complications in patients infected with dengue virus (DENV), finding a 9.26% incidence rate.
  • Significant predictors for central nervous system (CNS) involvement included higher body temperature, elevated hematocrit, low platelet count, and liver dysfunction, while peripheral nervous system (PNS) involvement was associated with body temperature and rash.
  • The overall mortality rate was 4.5%, with the majority of patients recovering, indicating a notable range of neurologic issues linked to DENV.

Article Abstract

Objective: This study aimed to evaluate the incidence and clinical spectrum of neurologic complications, predictors of central and peripheral nervous system involvement, and their outcome in patients with dengue virus infection (DENV).

Methods: To determine the extent of neurologic complications, we used a hospital-based prospective cohort study design, which included laboratory-confirmed cases of dengue and follow-up for 3 months. We also analyzed clinical and laboratory data to assess predictors of neurologic involvement.

Results: The study included enrollment of 486 cases. Two were lost to follow-up and excluded. Forty-five patients developed neurologic complications. Of these, 28 patients had CNS and 17 had peripheral nervous system (PNS) involvement, representing an incidence rate for neurologic complications of 9.26%. Significant predictors of CNS involvement were higher mean body temperature (p = 0.012), elevated hematocrit (p = 0.009), low platelet count (p = 0.021), and liver dysfunction (p < 0.001). Predictors of PNS involvement were higher mean body temperature (p = 0.031), rash (p = 0.002), and elevated hematocrit (p < 0.001). The mortality rate was 4.5%. The remainder of the patients recovered.

Conclusion: An increasingly wide spectrum and higher incidence of neurologic complications of DENV are reported. Clinical and laboratory parameters such as higher mean body temperature, rash, increases in hematocrit, thrombocytopenia, and liver dysfunction are independent predictors of neurologic complications.

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Source
http://dx.doi.org/10.1212/WNL.0000000000000935DOI Listing

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