DOI: https://doi.org/10.14710/jphtcr.v8i3.27334

Prognostic Factors of Severe Dengue Based on Individual Characteristics And Laboratory Examination: A Scoping Review

1Field Epidemiology Training Program, Faculty of Public Health, Univeristas Diponegoro, Semarang, Jawa Tengah , Indonesia

2Department of Epidemiology and Tropical Disease, Faculty of Public Health, Univeristas Diponegoro, Semarang, Jawa Tengah , Indonesia

3Department of of Biostatistic and Population Studies, Faculty of Public Health, Univeristas Diponegoro, Semarang, Jawa Tengah , Indonesia

Received: 27 May 2025; Published: 30 Dec 2025.
Open Access Copyright (c) 2025 The authors. Published by Faculty of Public Health, Universitas Diponegoro
Creative Commons License This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

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Abstract

Introduction: Dengue fever is a major health problem in 48 countries worldwide. Complications and death can occur in patients who experience shock or prolonged infection. Dengue severity can be predicted based on individual characteristics and laboratory test results. However, previous studies have reported different prognostic factors. This review aimed to identify the characteristics and laboratory findings associated with severe dengue.

Methods: The inclusion criteria were observational studies published between January 2016 and May 2025 in the Scopus, PubMed, and Google Scholar databases, written in Indonesian or English, and available in full texts. Articles other than observational studies and those that did not provide PR/OR/RR were excluded from the study. Thirteen studies were eligible for assessment. This study followed the Preferred Reporting Items for Systematic Literature Reviews and Meta-Analyses (PRISMA) guidelines.

Results: Patient characteristics that served as prognostic factors for severe dengue included male sex, abnormal nutritional status, age 15–49 years, presence of comorbidities, and receiving health care for more than 1–2 days of hospitalization. Laboratory findings that act as prognostic factors include hemoconcentration, thrombocytopenia, leukopenia, and low hemoglobin levels. Based on patient characteristics, the dominant prognostic factors were comorbidities, nutritional status, and duration of healthcare. According to the laboratory findings, the dominant factors were hemoconcentration and thrombocytopenia.

Conclusion: The dominant prognostic factors for severe dengue are comorbidities such as hypertension, cardiovascular disease, and hemoconcentration. Further studies using a robust and comprehensive methodological approach are needed to validate the relationship between these prognostic factors.

Note: This article has supplementary file(s).

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Keywords: Severity, Dengue Infection, Prognostic Factors, Dengue Shock Syndrome

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  1. World Health Organization (WHO). Dengue and severe dengue. In 2024. Available from: https://www.who.int/news-room/fact-sheets/detail/dengue-and-severe-dengue
  2. European Centre for Disease Prevention and Control. Dengue worldwide overview. In 2025. Available from: https://www.ecdc.europa.eu
  3. Magelang City Health Office. Magelang City Health Profile 2021. Ed 6(11), 951–952. 2022
  4. Indonesia Ministry of Health. Indonesia Health Profile 2023
  5. Indonesia Ministry of Health. Waspada Penyakit di Musim Hujan. In Bureau of Communication and Public Service; 2024. Available from: https://kemkes.go.id/id/waspada-penyakit-di-musim-hujan#:~:text=Pada minggu ke-43 tahun,kabupaten%2Fkota di 32 provinsi
  6. World Health Organization (WHO). Comprehensive guidelines for prevention and control of dengue hemorrhagic fever [Internet]. World Health Organization (WHO); 2011. Available from: https://who.int
  7. Nurlim R, Haristiani R, Biologi T, Training T, Kiai U, Achmad H, et al. The association between clinical symptoms (fever, dizziness/headache, muscle/joint pain, vomiting, and gum bleeding) and the severity of dengue infection. J Kesehat Pertiwi [Internet]. 2022;4:2022
  8. Andriawan FR, Kardin L, Rustam HN M. The Association Between Nutritional Status and the Severity of Dengue Infection in Patients with Dengue Hemorrhagic Fever. Nurs Care Heal Technol J. 2022;2(1):8–15
  9. Abdu S. Laboratory Risk Factor Analysis of Dengue Shock Syndrome Occurrence in Patients with Dengue Hemorrhagic Fever. Sustain [Internet]. 2016;11(1):1–14
  10. Jayani I, Fadilah C. Association Between Nutritional Status and Clinical Severity of Dengue Hemorrhagic Fever (DHF). Nurs Sci J. 2019;1(September 2017):1–10
  11. Kharisma PL, Muhyi A, Rachmi E. The Association of Nutritional Status, Age, and Gender with the Severity of Dengue Infection in Children at Abdul Wahab Sjahranie Regional General Hospital, Samarinda. J Sains dan Kesehat. 2021;3(3):376–82
  12. Yulianto A, Laksono IS, Juffrie M. Prognostic Factors of Dengue Infection Severity. Sari Pediatr. 2017;18(3):198
  13. LaupacisA, Wells, Richardson E al. How to use an article about prognosis. JAMA. 1994;272:234
  14. Fletcher R FS. Clinical epidemiology: the essentials 5th Edition. Lippincott Williams & Wilkins. 2013
  15. Mak K KC. How to Appraise a Prognostic Study. World J Surg. 2005;29:567–9
  16. Edwin J, Olivia Budiarta M, Edward Departemen Kesehatan Anak RSIA Bunda Aliyah K, Timur J. 109 Sari Pediatri. 2019;21(2):109–14
  17. Lestari KD. Risk Factors Associated with Dengue Shock Syndrome Among Dengue Hemorrhagic Fever Patients at Sanglah Regional Hospital, Denpasar, 2015. Medicina (B Aires). 2018;49(3)
  18. Bernal C, Ping S, Rojas A, Caballero O, Stittleburg V, De Guillén Y, et al. Serum biomarkers and anti-flavivirus antibodies at presentation as indicators of severe dengue. PLoS Negl Trop Dis. 2023;17(2):1–18
  19. Ng WY, Atan R, Yunos NM, Bin Md Kamal AH, Roslan MH, Quah KY, et al. A double whammy: The association between comorbidities and severe dengue among adult patients—A matched case-control study. PLoS One [Internet]. 2022;17(9 September):1–15. Available from: http://dx.doi.org/10.1371/journal.pone.0273071
  20. Carras M, Maillard O, Cousty J, Gérardin P, Boukerrou M, Raffray L, et al. Associated risk factors of severe dengue in Reunion Island: A prospective cohort study. PLoS Negl Trop Dis. 2023;17(4 April):1–12
  21. Agung A, Indira P, Windiyanto R. Faktor risiko kejadian dengue shock syndrome pada anak di RSUD Sanjiwani Gianyar periode Januari 2021 sampai September 2022. 2023;14(2):748–52
  22. Satari HI, Mardani RA, Gunardi H. Faktor Prognosis Sindrom Syok Dengue pada Anak. Sari Pediatr. 2018;20(3):131
  23. Haddaway, N. R., Page, M. J., Pritchard, C. C., & McGuinness LA. PRISMA2020: An R package and Shiny app for producing PRISMA 2020 [Internet]. Open Synth. 2022. 1230 p. Available from: https://doi.org/10.1002/cl2.1230
  24. Hernawan B, Afrizal AR. Hubungan antara Jenis Kelamin dan Usia dengan Kejadian Dengue Syok Sindrom pada Anak di Ponorogo. Publ Ilm. 2020;80–8
  25. Sumarmo S, Poorwo Soedarmo dkk. Buku Ajar Infeksi & Pediatri Tropis [Internet]. 2nd ed. UKK Infeksi dan Penyakit Tropis IDAI; 2008. Available from: https://www.scribd.com/document/356321980/BUKU-AJAR-INFEKSI-DAN-PEDIATRI-TROPIS-IDAI-2008-pdf
  26. Tule NRS. Systematic Review: Identifikasi Faktor Jenis Kelamin Dan Kelompok Usia Pada Pasien Demam Berdarah Dengue Dengan Pendekatan Kasus Trombositopenia. Univ ’Aisyiyah [Internet]. 2020;1–11
  27. Hidayat, Triwahyuni T, Zulfian Z, Iskandar FF. Perbandingan Kelainan Hematologi Antara Pasien Infeksi Dengue Primer Dan Sekunder Di Rsud Dr. H. Abdul Moeloek Provinsi Lampung. J Ilmu Dan Teknol Kesehat Terpadu. 2021;1(1):28–37
  28. Côrtes N, Lira A, Prates-Syed W, Dinis Silva J, Vuitika L, Cabral-Miranda W, et al. Integrated control strategies for dengue, Zika, and Chikungunya virus infections. Front Immunol. 2023;14
  29. Erawati E, Kusumawardani S, Umaya DN. Gambaran Respon Imun Igg Igm Dengue Dan Kadar Trombosit Pada Pasien Suspek DBD di Kota Kediri. J Insa Cendekia. 2023;10(2):118–25
  30. Kan EF, Rampengan TH. Factors associated with shock in children with dengue hemorrhagic fever. Paediatr Indones. 2016;44(5):171
  31. Wilhelmina VM, Suryawan IWB, Suarca K. Hubungan indeks platelet dengan derajat keparahan penyakit demam berdarah dengue pada anak di RSUD Wangaya. Intisari Sains Medis. 2021;12(2):635–9
  32. Mahdalena M, Widiyati T, Laksanawati IS, Prawirohartono EP. Paediatrica Indonesiana. 2013;53(4):187–92
  33. Junia J, Garna H, Setiabudi D. Clinical risk factors for dengue shock syndrome in children. Paediatr Indones. 2007;47(1):7
  34. Nguyen TH, Nguyen TL, Lei HY, Lin YS, Le BL, Huang KJ, et al. Association between sex, nutritional status, severity of dengue hemorrhagic fever, and immune status in infants with dengue hemorrhagic fever. Am J Trop Med Hyg. 2005 Apr;72(4):370–4
  35. Prijanto SA, Suryawan IWB, and Suarca IK. Rasio Neutrofil-Limfosit sebagai Prediktor Kejadian Syok pada Demam Berdarah Dengue pada Anak di Rumah Sakit Umum Daerah Wangaya, Denpasar. Sari Pediatr. 2023;24(5):307
  36. Yang X, Quam MBM, Zhang T, Sang S. Global burden for dengue and the evolving pattern in the past 30 years. J Travel Med. 2021;28(8):1–11
  37. Yang J, Al Mosabbir A, Raheem E, Hu W, Hossain MS. Demographic characteristics, clinical symptoms, biochemical markers and probability of occurrence of severe dengue: A multicenter hospital-based study in Bangladesh. PLoS Negl Trop Dis [Internet]. 2023;17(3):1–14. Available from: http://dx.doi.org/10.1371/journal.pntd.0011161
  38. Leng X, Yang H, Hong W, He J, Wang J, He X, et al. Severe Organ Impairment Was Common in Elderly Individuals with Dengue in Guangdong, China. Am J Trop Med Hyg. 2024;111(3):610–6
  39. Furuta T, Murao LA, Lan NTP, Huy NT, Huong VTQ, Thuy TT, et al. Association of mast cell-derived VEGF and proteases in dengue shock syndrome. PLoS Negl Trop Dis. 2012;6(2)
  40. St John AL, Rathore APS, Raghavan B, Ng ML, Abraham SN

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