Dengue clinical features and harbingers of severity in the diabetic patient: A retrospective cohort study on Reunion island, 2019
Aim: Diabetes mellitus is associated with both the risks of severe dengue and dengue-related deaths, however the factors characterizing dengue in the diabetic patient are ill-recognized. The objective of this hospital-based cohort study was to identify the factors characterizing dengue and those abl...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-07-01
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| Series: | Travel Medicine and Infectious Disease |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1477893923000467 |
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| author | Azizah Issop Antoine Bertolotti Yves-Marie Diarra Jean-christophe Maïza Éric Jarlet Muriel Cogne Éric Doussiet Éric Magny Olivier Maillard Estelle Nobécourt Patrick Gérardin Jeanne Belot Mathilde Cadic Mathys Carras Romain Chane-Teng Romane Crouzet David Hirschinger Anne-Cecilia Etoa N’Doko Azizah Issop Mathilde Legros Mamitiana Randriamanana Cédric Rosolen Nolwenn Sautereau |
| author_facet | Azizah Issop Antoine Bertolotti Yves-Marie Diarra Jean-christophe Maïza Éric Jarlet Muriel Cogne Éric Doussiet Éric Magny Olivier Maillard Estelle Nobécourt Patrick Gérardin Jeanne Belot Mathilde Cadic Mathys Carras Romain Chane-Teng Romane Crouzet David Hirschinger Anne-Cecilia Etoa N’Doko Azizah Issop Mathilde Legros Mamitiana Randriamanana Cédric Rosolen Nolwenn Sautereau |
| author_sort | Azizah Issop |
| collection | DOAJ |
| description | Aim: Diabetes mellitus is associated with both the risks of severe dengue and dengue-related deaths, however the factors characterizing dengue in the diabetic patient are ill-recognized. The objective of this hospital-based cohort study was to identify the factors characterizing dengue and those able to early identify dengue severity in the diabetic patient. Methods: We retrospectively analysed demographic, clinical and biological parameters at admission in the cohort of patients who consulted at the university hospital between January and June 2019 with confirmed dengue. Bivariate and multivariate analyses were conducted. Results: Of 936 patients, 184 patients (20%) were diabetic. One hundred and eighty-eight patients (20%) developed severe dengue according to the WHO 2009 definition. Diabetic patients were older and had more comorbidities than non-diabetics. In an age-adjusted logistic regression model, loss of appetite, altered mental status, high neutrophil to platelet ratios (>14.7), low haematocrit (≤ 38%), upper-range serum creatinine (>100 µmol/l) and high urea to creatinine ratio (>50) were indicative of dengue in the diabetic patient. A modified Poisson regression model identified four key independent harbingers of severe dengue in the diabetic patient: presence of diabetes complications, non-severe bleeding, altered mental status and cough. Among diabetes complications, diabetic retinopathy and neuropathy, but not diabetic nephropathy nor diabetic foot, were associated with severe dengue. Conclusion: At hospital first presentation, dengue in the diabetic patient is characterized by deteriorations in appetite, mental and renal functioning, while severe dengue can be early identified by presence of diabetes complications, dengue-related non-severe haemorrhages, cough, and dengue-related encephalopathy. |
| first_indexed | 2024-03-12T15:31:51Z |
| format | Article |
| id | doaj.art-cdf24bb7b3e2429aa0e115e8732a72b4 |
| institution | Directory Open Access Journal |
| issn | 1873-0442 |
| language | English |
| last_indexed | 2024-03-12T15:31:51Z |
| publishDate | 2023-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Travel Medicine and Infectious Disease |
| spelling | doaj.art-cdf24bb7b3e2429aa0e115e8732a72b42023-08-10T04:33:56ZengElsevierTravel Medicine and Infectious Disease1873-04422023-07-0154102586Dengue clinical features and harbingers of severity in the diabetic patient: A retrospective cohort study on Reunion island, 2019Azizah Issop0Antoine Bertolotti1Yves-Marie Diarra2Jean-christophe Maïza3Éric Jarlet4Muriel Cogne5Éric Doussiet6Éric Magny7Olivier Maillard8Estelle Nobécourt9Patrick Gérardin10Jeanne BelotMathilde CadicMathys CarrasRomain Chane-TengRomane CrouzetDavid HirschingerAnne-Cecilia Etoa N’DokoAzizah IssopMathilde LegrosMamitiana RandriamananaCédric RosolenNolwenn SautereauService d’Endocrinologie et Diabétologie, Centre Hospitalier Universitaire Réunion, Saint Pierre, La Réunion, FranceINSERM, CIC 1410, Centre Hospitalier Universitaire Réunion, Saint-Pierre, La Réunion, France; Service des Maladies Infectieuses, Médecine Interne, Dermatologie, Centre Hospitalier Universitaire Réunion, Saint Pierre, La Réunion, FranceINSERM, CIC 1410, Centre Hospitalier Universitaire Réunion, Saint-Pierre, La Réunion, France; UMR PIMIT (CNRS 9192, INSERM U1187, IRD 249, Université de La Réunion), Sainte Clotilde, La Réunion, FranceService d’Endocrinologie et Diabétologie, Centre Hospitalier Universitaire Réunion, Saint Pierre, La Réunion, FranceService d’Endocrinologie et Diabétologie, Centre Hospitalier Universitaire Réunion, Saint Pierre, La Réunion, FranceService d’Endocrinologie et Diabétologie, Centre Hospitalier Universitaire Réunion, Saint Pierre, La Réunion, FranceService d’Endocrinologie et Diabétologie, Centre Hospitalier Universitaire Réunion, Saint Pierre, La Réunion, France; Plateforme de Recherche Clinique et Translationnelle, Centre Hospitalier Universitaire, Réunion, Saint-Pierre, La Réunion, FranceService de Biochimie, Centre Hospitalier Universitaire Réunion, Saint Pierre, La Réunion, FranceINSERM, CIC 1410, Centre Hospitalier Universitaire Réunion, Saint-Pierre, La Réunion, FranceService d’Endocrinologie et Diabétologie, Centre Hospitalier Universitaire Réunion, Saint Pierre, La Réunion, France; INSERM, CIC 1410, Centre Hospitalier Universitaire Réunion, Saint-Pierre, La Réunion, France; UMR Diabète Athérothrombose Thérapies Réunion Océan Indien (DéTROI) (INSERM U1188), Plateforme CYROI, University of La Réunion, Sainte Clotilde, La Réunion, FranceINSERM, CIC 1410, Centre Hospitalier Universitaire Réunion, Saint-Pierre, La Réunion, France; Plateforme de Recherche Clinique et Translationnelle, Centre Hospitalier Universitaire, Réunion, Saint-Pierre, La Réunion, France; Corresponding author. INSERM CIC1410 / Plateforme de Recherche Clinique et Translationnelle, Centre Hospitalier Universitaire Réunion, Groupe Hospitalier Sud Réunion, BP 350, 97448, Saint Pierre Cedex. Réunion island, France.Aim: Diabetes mellitus is associated with both the risks of severe dengue and dengue-related deaths, however the factors characterizing dengue in the diabetic patient are ill-recognized. The objective of this hospital-based cohort study was to identify the factors characterizing dengue and those able to early identify dengue severity in the diabetic patient. Methods: We retrospectively analysed demographic, clinical and biological parameters at admission in the cohort of patients who consulted at the university hospital between January and June 2019 with confirmed dengue. Bivariate and multivariate analyses were conducted. Results: Of 936 patients, 184 patients (20%) were diabetic. One hundred and eighty-eight patients (20%) developed severe dengue according to the WHO 2009 definition. Diabetic patients were older and had more comorbidities than non-diabetics. In an age-adjusted logistic regression model, loss of appetite, altered mental status, high neutrophil to platelet ratios (>14.7), low haematocrit (≤ 38%), upper-range serum creatinine (>100 µmol/l) and high urea to creatinine ratio (>50) were indicative of dengue in the diabetic patient. A modified Poisson regression model identified four key independent harbingers of severe dengue in the diabetic patient: presence of diabetes complications, non-severe bleeding, altered mental status and cough. Among diabetes complications, diabetic retinopathy and neuropathy, but not diabetic nephropathy nor diabetic foot, were associated with severe dengue. Conclusion: At hospital first presentation, dengue in the diabetic patient is characterized by deteriorations in appetite, mental and renal functioning, while severe dengue can be early identified by presence of diabetes complications, dengue-related non-severe haemorrhages, cough, and dengue-related encephalopathy.http://www.sciencedirect.com/science/article/pii/S1477893923000467Diabetes mellitusComorbiditiesDengueSevere DenguePrognosisCohort study |
| spellingShingle | Azizah Issop Antoine Bertolotti Yves-Marie Diarra Jean-christophe Maïza Éric Jarlet Muriel Cogne Éric Doussiet Éric Magny Olivier Maillard Estelle Nobécourt Patrick Gérardin Jeanne Belot Mathilde Cadic Mathys Carras Romain Chane-Teng Romane Crouzet David Hirschinger Anne-Cecilia Etoa N’Doko Azizah Issop Mathilde Legros Mamitiana Randriamanana Cédric Rosolen Nolwenn Sautereau Dengue clinical features and harbingers of severity in the diabetic patient: A retrospective cohort study on Reunion island, 2019 Travel Medicine and Infectious Disease Diabetes mellitus Comorbidities Dengue Severe Dengue Prognosis Cohort study |
| title | Dengue clinical features and harbingers of severity in the diabetic patient: A retrospective cohort study on Reunion island, 2019 |
| title_full | Dengue clinical features and harbingers of severity in the diabetic patient: A retrospective cohort study on Reunion island, 2019 |
| title_fullStr | Dengue clinical features and harbingers of severity in the diabetic patient: A retrospective cohort study on Reunion island, 2019 |
| title_full_unstemmed | Dengue clinical features and harbingers of severity in the diabetic patient: A retrospective cohort study on Reunion island, 2019 |
| title_short | Dengue clinical features and harbingers of severity in the diabetic patient: A retrospective cohort study on Reunion island, 2019 |
| title_sort | dengue clinical features and harbingers of severity in the diabetic patient a retrospective cohort study on reunion island 2019 |
| topic | Diabetes mellitus Comorbidities Dengue Severe Dengue Prognosis Cohort study |
| url | http://www.sciencedirect.com/science/article/pii/S1477893923000467 |
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