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Dengue clinical features and harbingers of severity in the diabetic patient: A retrospective cohort study on Reunion island, 2019
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...
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Published in: | Travel medicine and infectious disease 2023-07, Vol.54, p.102586-102586, Article 102586 |
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creator | Issop, Azizah Bertolotti, Antoine Diarra, Yves-Marie Maïza, Jean-christophe Jarlet, Éric Cogne, Muriel Doussiet, Éric Magny, Éric Maillard, Olivier Belot, Jeanne Cadic, Mathilde Carras, Mathys Chane-Teng, Romain Crouzet, Romane Hirschinger, David Etoa N’Doko, Anne-Cecilia Issop, Azizah Legros, Mathilde Randriamanana, Mamitiana Rosolen, Cédric Sautereau, Nolwenn Nobécourt, Estelle Gérardin, Patrick |
description | 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.
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.
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.
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. |
doi_str_mv | 10.1016/j.tmaid.2023.102586 |
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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.
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.
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.</description><identifier>ISSN: 1477-8939</identifier><identifier>EISSN: 1873-0442</identifier><identifier>DOI: 10.1016/j.tmaid.2023.102586</identifier><identifier>PMID: 37286121</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Cohort analysis ; Cohort study ; Cohorts ; Comorbidities ; Comorbidity ; Dengue ; Dengue fever ; Diabetes ; Diabetes mellitus ; Epidemics ; Haemorrhage ; Hospitals ; Human diseases ; Infections ; Infectious diseases ; Life Sciences ; Medical prognosis ; Medical records ; Patients ; Prognosis ; Serum ; Severe Dengue ; Sociodemographics ; Surveillance ; Travel medicine ; Urea ; Vector-borne diseases</subject><ispartof>Travel medicine and infectious disease, 2023-07, Vol.54, p.102586-102586, Article 102586</ispartof><rights>2023 The Author(s)</rights><rights>Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.</rights><rights>2023. The Author(s)</rights><rights>Attribution</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c532t-8ec151be2a9ad4576a0bd29cb452f0e1b42bca6e271749dffe1874ad3813c283</citedby><cites>FETCH-LOGICAL-c532t-8ec151be2a9ad4576a0bd29cb452f0e1b42bca6e271749dffe1874ad3813c283</cites><orcidid>0000-0002-3276-5919 ; 0000-0001-7427-0108</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37286121$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.univ-reunion.fr/hal-04542182$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Issop, Azizah</creatorcontrib><creatorcontrib>Bertolotti, Antoine</creatorcontrib><creatorcontrib>Diarra, Yves-Marie</creatorcontrib><creatorcontrib>Maïza, Jean-christophe</creatorcontrib><creatorcontrib>Jarlet, Éric</creatorcontrib><creatorcontrib>Cogne, Muriel</creatorcontrib><creatorcontrib>Doussiet, Éric</creatorcontrib><creatorcontrib>Magny, Éric</creatorcontrib><creatorcontrib>Maillard, Olivier</creatorcontrib><creatorcontrib>Belot, Jeanne</creatorcontrib><creatorcontrib>Cadic, Mathilde</creatorcontrib><creatorcontrib>Carras, Mathys</creatorcontrib><creatorcontrib>Chane-Teng, Romain</creatorcontrib><creatorcontrib>Crouzet, Romane</creatorcontrib><creatorcontrib>Hirschinger, David</creatorcontrib><creatorcontrib>Etoa N’Doko, Anne-Cecilia</creatorcontrib><creatorcontrib>Issop, Azizah</creatorcontrib><creatorcontrib>Legros, Mathilde</creatorcontrib><creatorcontrib>Randriamanana, Mamitiana</creatorcontrib><creatorcontrib>Rosolen, Cédric</creatorcontrib><creatorcontrib>Sautereau, Nolwenn</creatorcontrib><creatorcontrib>Nobécourt, Estelle</creatorcontrib><creatorcontrib>Gérardin, Patrick</creatorcontrib><creatorcontrib>Epidengue Cohort Investigation Team</creatorcontrib><title>Dengue clinical features and harbingers of severity in the diabetic patient: A retrospective cohort study on Reunion island, 2019</title><title>Travel medicine and infectious disease</title><addtitle>Travel Med Infect Dis</addtitle><description>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.
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.
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.
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.</description><subject>Cohort analysis</subject><subject>Cohort study</subject><subject>Cohorts</subject><subject>Comorbidities</subject><subject>Comorbidity</subject><subject>Dengue</subject><subject>Dengue fever</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Epidemics</subject><subject>Haemorrhage</subject><subject>Hospitals</subject><subject>Human diseases</subject><subject>Infections</subject><subject>Infectious diseases</subject><subject>Life Sciences</subject><subject>Medical prognosis</subject><subject>Medical records</subject><subject>Patients</subject><subject>Prognosis</subject><subject>Serum</subject><subject>Severe Dengue</subject><subject>Sociodemographics</subject><subject>Surveillance</subject><subject>Travel medicine</subject><subject>Urea</subject><subject>Vector-borne 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clinical features and harbingers of severity in the diabetic patient: A retrospective cohort study on Reunion island, 2019</title><author>Issop, Azizah ; Bertolotti, Antoine ; Diarra, Yves-Marie ; Maïza, Jean-christophe ; Jarlet, Éric ; Cogne, Muriel ; Doussiet, Éric ; Magny, Éric ; Maillard, Olivier ; Belot, Jeanne ; Cadic, Mathilde ; Carras, Mathys ; Chane-Teng, Romain ; Crouzet, Romane ; Hirschinger, David ; Etoa N’Doko, Anne-Cecilia ; Issop, Azizah ; Legros, Mathilde ; Randriamanana, Mamitiana ; Rosolen, Cédric ; Sautereau, Nolwenn ; Nobécourt, Estelle ; Gérardin, Patrick</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c532t-8ec151be2a9ad4576a0bd29cb452f0e1b42bca6e271749dffe1874ad3813c283</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Cohort analysis</topic><topic>Cohort 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Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Issop, Azizah</au><au>Bertolotti, Antoine</au><au>Diarra, Yves-Marie</au><au>Maïza, Jean-christophe</au><au>Jarlet, Éric</au><au>Cogne, Muriel</au><au>Doussiet, Éric</au><au>Magny, Éric</au><au>Maillard, Olivier</au><au>Belot, Jeanne</au><au>Cadic, Mathilde</au><au>Carras, Mathys</au><au>Chane-Teng, Romain</au><au>Crouzet, Romane</au><au>Hirschinger, David</au><au>Etoa N’Doko, Anne-Cecilia</au><au>Issop, Azizah</au><au>Legros, Mathilde</au><au>Randriamanana, Mamitiana</au><au>Rosolen, Cédric</au><au>Sautereau, Nolwenn</au><au>Nobécourt, Estelle</au><au>Gérardin, Patrick</au><aucorp>Epidengue Cohort Investigation Team</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Dengue clinical features and harbingers of severity in the diabetic patient: A retrospective cohort study on Reunion island, 2019</atitle><jtitle>Travel medicine and infectious disease</jtitle><addtitle>Travel Med Infect Dis</addtitle><date>2023-07-01</date><risdate>2023</risdate><volume>54</volume><spage>102586</spage><epage>102586</epage><pages>102586-102586</pages><artnum>102586</artnum><issn>1477-8939</issn><eissn>1873-0442</eissn><abstract>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.
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.
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.
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.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>37286121</pmid><doi>10.1016/j.tmaid.2023.102586</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0002-3276-5919</orcidid><orcidid>https://orcid.org/0000-0001-7427-0108</orcidid><oa>free_for_read</oa></addata></record> |
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ispartof | Travel medicine and infectious disease, 2023-07, Vol.54, p.102586-102586, Article 102586 |
issn | 1477-8939 1873-0442 |
language | eng |
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source | ScienceDirect Freedom Collection 2022-2024 |
subjects | Cohort analysis Cohort study Cohorts Comorbidities Comorbidity Dengue Dengue fever Diabetes Diabetes mellitus Epidemics Haemorrhage Hospitals Human diseases Infections Infectious diseases Life Sciences Medical prognosis Medical records Patients Prognosis Serum Severe Dengue Sociodemographics Surveillance Travel medicine Urea Vector-borne diseases |
title | Dengue clinical features and harbingers of severity in the diabetic patient: A retrospective cohort study on Reunion island, 2019 |
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