Association of Hematological Parameters with Disease Severity and Outcome in Children with Dengue Fever: A Hospital-Based Study
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: Dengue fever is an important mosquito-borne viral infection in children, ranging from uncomplicated febrile illness to severe dengue with plasma leakage, bleeding, shock or organ dysfunction. Hematological abnormalities, particularly thrombocytopenia and hemoconcentration may provide inexpensive indicators of disease progression. Early identification of high-risk children is important in resource-constrained settings. Objective: To determine the association between hematological parameters, disease severity and clinical outcomes among hospitalized children with dengue fever. Methods: This hospital-based observational study was conducted in the Department of Pediatrics, Mugda Medical College & Hospital, Dhaka, Bangladesh, from July 2025 to December 2025. A total of 120 laboratory-confirmed dengue cases were included. Demographic, clinical, and hematological data were recorded. Hemoglobin, hematocrit, total leukocyte count (TLC), platelet count, neutrophils, lymphocytes, red-cell distribution width (RDW) and mean platelet volume (MPV) were assessed. Disease severity was classified according to World Health Organization criteria. Associations with severe dengue, shock, bleeding and prolonged hospitalization were evaluated. ROC analysis assessed the discriminatory performance of selected hematological parameters. Results: The mean age was 9.1 ± 3.8 years and 68 (56.7%) participants were male. Severe dengue occurred in 24 (20.0%) children, including shock in 12 (10.0%), severe bleeding in 5 (4.2%) and severe organ involvement in 7 (5.8%). ICU/HDU admission occurred in 2 (1.7%), blood-component transfusion in 5 (4.2%) and one death (0.8%) was recorded. Platelet count <50×10³/µL and hematocrit ≥40% were strongly associated with severe dengue (OR 17.00, 95% CI 6.25–46.27; and OR 10.80, 95% CI 4.05–28.79, respectively; both p<0.001). Platelet count showed good discrimination (AUC 0.86), while the combined platelet–hematocrit model showed higher apparent discrimination (AUC 0.90). Conclusion: Thrombocytopenia and elevated hematocrit were strongly associated with severe dengue and adverse outcomes. Serial CBC monitoring alongside clinical assessment may aid early risk stratification, but these findings require validation in larger multicenter studies.
Source: Naogaon Medical College Journal
Institution: Mugda Medical College
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W7212374768