Factors associated with thrombocytopenia in patients with dengue fever: a retrospective cohort study

• Published in: BMJ open Vol. 10; no. 9; p. e035120
• Main Authors: Castilho, Bruna M, Silva, Marcus T, Freitas, André R R, Fulone, Izabela, Lopes, Luciane Cruz
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 13.09.2020; BMJ Publishing Group
• Series: Original research
• Subjects: Age; Aged; Blood platelets; Blood tests; Brazil - epidemiology; Cohort analysis; Dengue - complications; Dengue - epidemiology; Dengue fever; Ethnicity; Health surveillance; Hematology; Hemoglobin; Higher education; Humans; Infections; Laboratories; Male; Middle Aged; Patients; Platelet Count; Public Health; Retrospective Studies; Serology; Statistical analysis; Thrombocytopenia; Thrombocytopenia - complications; Thrombocytopenia - epidemiology; Variables; Brazil; epidemiology; virology; public health
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2019-035120

Some patients with dengue fever tend to develop thrombocytopenia during the course of infection and are thus vulnerable to haemorrhagic manifestations and other complications. However, the factors associated with the development of thrombocytopenia are unknown. We aimed to identify factors associated with an increased risk of thrombocytopenia and haematological changes in patients with confirmed dengue fever. Retrospective cohort study. Brazilian multicentre primary care databases. 387 patients had positive laboratory serological confirmation of dengue infection during 2014. The data were identified from two databases: Notification of Injury Information System (SINAN) and Municipal Laboratory. The presence of thrombocytopenia (platelet count <1 50×10 /L). The associations of factors that predisposed patients to thrombocytopenia and haematological changes were analysed using logistic regression. ORs and 95% CIs were calculated. Among 387 patients, 156 had both dengue and thrombocytopenia. The risk factors associated with thrombocytopenia included male sex (OR: 1.77, 95% CI: 1.16 to 2.71, p=0.007), age of 46-64 years (OR: 2.20, 95% CI: 1.15 to 4.21, p=0.009) or ≥65 years (OR: 3.02, 95% CI: 1.40 to 6.50, p=0.002), presence of leucopenia (OR: 6.85, 95% CI: 4.27 to 10.99, p<0.001) and high mean corpuscular haemoglobin (MCH) levels (OR: 2.00, 95% CI: 1.29 to 3.12, p=0.005). Older age, male sex, presence of leucopenia and high MCH levels were identified as risk factors associated with the development of thrombocytopenia in this population.