Acute Respiratory Distress Syndrome in Dengue Shock: Exploring Serotype-Specific Risk Factors and Outcomes

VinodKumar CS, Prasad BS, Kalappanavar NK, Jayasimha VL, Ananya VS and Bharadwaj VVCS

Published on: 2024-08-19

Abstract

This study provides an in-depth analysis of 2256 clinically suspected dengue cases, focusing on demographic characteristics, clinical features, serotype distribution, and outcomes, particularly severe manifestations like Acute Respiratory Distress Syndrome (ARDS). The cohort was predominantly male (62.6%) and from rural areas (60.1%). Dengue positivity by RT-PCR was 57.9%, with DENV-2 being the most prevalent serotype in single infections (54.2%) and in concurrent infections with DENV-3 (67.8%). Common clinical features included fever (100%), retro-orbital pain (85.9%), flushing (77.5%), and rashes (84.8%). Severe manifestations included ARDS (9.7%), splenomegaly (27.5%), ascites (20.3%), and encephalopathy (3.4%). Among the RT-PCR positive cases, 50.5% were classified as classical dengue fever, 28.8% as dengue hemorrhagic fever, and 20.7% as dengue shock syndrome.

Focusing on 127 severe dengue cases with ARDS, all patients exhibited acute symptoms of rapid breathing, severe hypoxemia, and lab abnormalities such as thrombocytopenia and elevated aminotransferases. Initial oxygen therapy was provided via non-rebreathing masks, but most patients required mechanical ventilation. The median duration of mechanical ventilation was 4 days, with a median hospital stay of 8 days. Complications included ventilator-associated pneumonia (7.1%) and sepsis (3.9%). Despite the severity, the mortality rate was low (0.8%).

This study’s findings align with existing literature on dengue, highlighting the critical need for effective clinical management, especially for severe cases. Future research should focus on understanding concurrent infections and enhancing preventive measures in endemic regions.