Fig 1.
A. Diagram of the time-line for data collection. B. Flow diagram representation of study inclusion and exclusion criteria. Exclusion criteria included recumbent systolic blood pressure <85 mmHg, significant bleeding prior to study enrollment, and patients unlikely to attend or that did not attend follow-up visits. 149 patients completed the protocol. 1 Headache, myalgia or maculopapular rash; 2 Routine laboratory testing: complete blood counts, PT, PTT, TT, albumin, AST and ALT. Specialized coagulation studies: TAT, F1+2, fibrinogen, D-D and vWF; 3 Signs of hypovolemia were defined using the following criteria: (heart rate / systolic blood pressure) ≥ 1 or (systolic–diastolic blood pressure) ≤ 20 mmHg; HI: hemagglutination inhibition; RT-PCR: reverse transcription polymerase chain reaction.
Table 1.
Description of the study population
Fig 2.
Overview of the blood biomarkers changes between the different groups.
A. Significant changes in blood markers for each day using Mann-Whitney U test. D0 represent the day of defervescence. In the comparison dengue VS other febrile illnesses, dengue comprises both dengue fever and severe dengue cases. B. Significant changes in blood biomarkers kinetic and intercept using the piecewise linear mixed effect regression model. Before and after represent two slopes while intercept is the biomarker’s value on D0. Blue, significant decrease. Red, significant increase.
Fig 3.
Evolution of selected blood biomarkers for selected groups comparison over the course of disease.
A. Evolution of the medians (and interquartile ranges) with comparison between dengue and other febrile illness patients. B. Evolution of the biomarkers at patient level using piecewise linear mixed effects models with comparison between dengue and other febrile illness patients. C. Evolution of the medians (and interquartile ranges) with comparison between dengue fever and severe dengue patients. In A and C, the linking lines are displayed for a better visualization but do not represent the evolution of the biomarkers at patient level. D0 is the day of defervescence.
Table 2.
Evolution of the receiver operating characteristics statistics for selected biomarkers over the course of disease.
Classification between the dengue and OFI groups. First contact: day of first contact with healthcare (independently of the day of fever). Median days -2 to 1: a posteriori calculation of the biomarker’s median value between D-2 and D+1. AUC: area under the curve; CI: confidence interval.
Fig 4.
Evolution of neutrophils and lymphocytes absolute counts and their ratio.
A. Evolution of the neutrophils and lymphocytes absolute counts’ medians for dengue patients. B. Evolution of the neutrophils over lymphocytes ratio and selected cutoffs (method used) to differentiate between D0 and any previous day. The intervals represent the range between the first and the third quartiles. (- - -) sensitivity = 0.80, specificity = 0.65; (·····) sensitivity = 0.47, specificity = 0.90.