Clinical profile of critically ill patients admitted with Dengue in a tertiary level hospital in Nepal: A retrospective study

G. S. Shrestha, A. Pradhan, Satyam Kharga, Manjit Shrestha, Tenzing Lobsel, Birendra Kumar Raut, Bal Chandra Karki, N. Poudel, R. Gautam, N. Maharjan
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Abstract

BACKGROUND AND AIMS Dengue is a viral disease transmitted by mosquitoes. The burden of disease related to Dengue is considerable in tropical and sub-tropical countries. Recently, many countries observed the outbreak of Dengue. Our study aims to explore the clinical profile and outcome of the dengue positive cases admitted in the intensive care unit (ICU) of a tertiary level hospital in Lalitpur. METHODS We conducted a retrospective single center study in patients with proven Dengue, admitted to ICU. Data were collected between 20th August and 15th October 2022. Data collected were the baseline characteristics of patients, signs and symptoms and need for organ support. Patients were graded according to WHO severity scale. RESULTS A total of 31 cases were admitted during the study period. Fever, vomiting and malaise were the common presenting symptoms. Comorbidities like hypertension and diabetes were common. Hypotension, requiring inotropic support was present in nine (29.0%) of cases. Ten patients (32.3%) required respiratory support. Derange hepatic and renal function were common. Five patients (16.1%) presented with clinically significant bleeding. Six (19.4%) of the cases expired in ICU. Among the non-survivors, five (83.3%) had severe Dengue and one (16.7%) case had Dengue with warning signs. CONCLUSION Critically ill patients with Dengue have multisystem involvement. Severe Dengue and Dengue with warning signs is associated with significant morbidity and mortality.
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尼泊尔一家三级医院收治的重症登革热患者的临床概况:一项回顾性研究
背景和目的登革热是一种由蚊子传播的病毒性疾病。在热带和亚热带国家,与登革热有关的疾病负担相当大。最近,许多国家都出现了登革热疫情。本研究旨在探讨拉利特普尔一家三级医院重症监护病房收治的登革热阳性病例的临床概况和结果。方法:我们对ICU收治的确诊登革热患者进行回顾性单中心研究。数据收集于2022年8月20日至10月15日。收集的数据包括患者的基线特征、体征和症状以及器官支持需求。根据WHO严重程度量表对患者进行分级。结果研究期间共收治31例患者。发烧、呕吐和不适是常见的症状。高血压和糖尿病等合并症很常见。9例(29.0%)患者出现低血压,需要肌力支持。10例(32.3%)患者需要呼吸支持。肝肾功能异常常见。5例患者(16.1%)出现临床显著出血。6例(19.4%)在ICU死亡。在非幸存者中,5例(83.3%)为重症登革热,1例(16.7%)为有警示迹象的登革热。结论重症登革热患者存在多系统累及。严重登革热和有警告迹象的登革热与显著的发病率和死亡率相关。
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