An institution-based study on Hematological profile of Dengue patients at a tertiary care hospital in Konkan region of Maharashtra

ABSTRACT

Background: Dengue is the most rapidly spreading mosquito-borne viral fever especially in coastal regions due to heavy rainfalls. It is important to understand the hemato-pathological changes associated with dengue infections to avoid dreaded hematological complications. These hematological changes can be used as diagnostic aid in remote rural set-ups wherein rapid dengue diagnostic kits are not available. Objective: This retrospective study was carried out from 1st January 2018 to 31st August 2021 with an objective to analyze the hematological profile of serologically diagnosed dengue patients. Materials and Methods: A cross sectional, observational, retrospective study was carried out at a tertiary care center at Dervan, Konkan region of Maharashtra over a period of three years and eight months. Commercially available ‘Dengue Day 1 test kit’ was used to detect NS1 antigen and IgM and IgG antibodies. Patients with positive NS1 antigen and/or IgM or IgG antibody were included while patients with other febrile illnesses like typhoid, malaria were excluded from this study. Patient’s venous blood was collected in plain bulb for serology and in EDTA bulb for hematological profile (CBC/blood smear). This profile included hemoglobin, hematocrit (HCT), RBC indices like MCV, MCH And MCHC, total leucocyte count (TLC), Differential leucocyte count (DLC) and platelet count (PC). Results: A total of 330 patients were diagnosed as dengue cases based on rapid card test. Majority of the patients were positive for NS1 antigen (60%) followed by IgM antibody (27.87%). Male female ratio was 1.81. Age of the patients were in the range of 10-65 years whereas majority of NS1 positivity was seen in the age group of 21-30 years. Hemoglobin levels among these patients ranged from 3.1-19.9 g/dl. 27.47% cases had hemoglobin level of more than 15 g/dl and 16.96% patients had hemoglobin level <10 g/dl. 225 out of 330 patients showed hematocrit (HCT) >35% above the average reference value. HCT ranging from 20-35% was seen in 72/330 (21.82%) patients. 143/330 (43.34%) cases showed TLC <4000/cumm (leukopenia). 51.07% patients showed relative lymphocytosis with 15.15% of these cases showing reactive lymphocytosis. Maximum cases showed thrombocytopenia (69.32%). 31.21% showed grade 1 thrombocytopenia that is, platelets between 75000-150000/cumm. This grade was followed sequentially by Grade III, II and IV thrombocytopenia cases. Conclusion: This study highlights important hematological parameters on different serological dengue diagnosis made on rapid card test. This study will help diagnose dengue disease in remote, rural set-ups wherein rapid diagnostic kits are not available.