Correlation of Vitamin B12 Levels with Clinical Manifestations, Thrombocytopenia, Hospital Stay, and Platelet Recovery in Dengue Patients

Abstract

Dengue is a prevalent viral infection with diverse clinical manifestations. This study aims to examine the impact of low vitamin B12 levels in dengue patients, to explore the prevalence of serum vitamin B12 deficiency in dengue patients and its correlation with clinical manifestations, severity of thrombocytopenia, hospital stay, units of platelets transfused, and patient outcomes. This was conducted as a prospective cross-sectional study at MLNMC, Prayagraj, on 250 dengue patients. Among them, 189 tested positive for dengue serology. After excluding 5 patients, our detailed study focused on 184 subjects with serum vitamin B12 levels ranging from < 83 to > 2000 ng/ml. The prevalence of vitamin B12 deficiency among dengue cases was 37.0%. Notably, cases with vitamin B12 levels < 200 ng/ml were more likely to exhibit melena (20.6% vs. 6.9%) and epistaxis (10.3% vs. 0.9%) and conversely lesser incidence of joint pains (69.1% vs. 87.9%). MCV levels were significantly higher in cases with B12 levels < 200 ng/ml (96.78 ± 9.76 vs. 84.13 ± 7.14 femtolitres/cell). Platelet counts at presentation were significantly higher in cases with vitamin B12 ≥ 200 ng/ml (0.74 ± 0.43 vs. 0.56 ± 0.32 lacs/µl). Furthermore, cases with vitamin B12 < 200 ng/ml experienced higher rates of indoor admissions (92.6% vs. 75.0%) and longer hospital stays (4.38 ± 2.23 vs. 3.52 ± 2.60 days) and required more platelet transfusion units (4.63 ± 2.60 vs. 3.11 ± 1.99 days). Vitamin B12 levels play a crucial role in the clinical manifestations of dengue and are associated with increased severity of thrombocytopenia, prolonged hospital stays, and heightened requirements for platelet transfusion.