Biochemical and Hematological Parameters among Patients of Mild and Severe Dengue: A Preliminary Study
Abstract
Background: Dengue fever, a mosquito-borne viral disease caused by the Dengue virus (DENV), represents a diverse set of clinical manifestations that range from mild febrile illness to severe complications such as Dengue Hemorrhagic Fever (DHF) and Dengue Shock Syndrome (DSS). Severity caused by Dengue virus has been attributed to the occurrence of more than one DENV strain. However, there can be other pre-existing factors in the patients that may also add to the severity. This study focuses on analyzing and comparing the clinical observations as well as the biochemical assays of the dengue infected patients. Methods: The indoor patients (IPD) of Sharda Hospital who were confirmed cases of Dengue were taken for the study. The patients were divided into two categories: severe Dengue cases (ICU cases also included) and mild dengue cases. The Complete Blood Count (CBC), KFT (Kidney Function Test), LFT (Liver Function Test), etc. were analyzed. Results: It was observed that sodium level and total protein (liver) were low and chloride level and SGOT were high in some of the mild and severe patients. In a few cases the levels of monocytes were high, whereas TLC, lymphocytes, and neutrophils were observed to be low in the case of severe patients and high in a few cases of mild patients. These patients were mostly infected with a single strain; however, multiple DENV strains were also reported. Conclusion: The present study sensitizes the need to add these biochemical parameters and diagnose type-specific DENV infection to provide improvised and targeted clinical solutions.
Keywords:
Biochemical, Blood Parameters, Dengue Virus, DHF, DSS, Serotypes
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References
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Azin, F. R. F. G., Gonçalves, R. P., Pitombeira, M. H. D. S., Lima, D. M., & Castelo Branco, I. (2012). Dengue: profile of hematological and biochemical dynamics. Revista Brasileira De Hematologia E Hemoterapia, 34(1), 36-41. https://doi.org/10.5581/1516-8484.20120012
Balmaseda, A., Hammond, S. N., Pérez, L., Tellez, Y., Saborío, S. I., Mercado, J. C., Cuadra, R., Rocha, J., Pérez, M. A., Silva, S., Rocha, C., & Harris, E. (2006). Serotype-specific differences in clinical manifestations of dengue. The American Journal of Tropical Medicine and Hygiene, 74(3), 449–456. https://doi.org/10.4269/ajtmh.2006.74.449
Brady, O. J., Gething, P. W., Bhatt, S., Messina, J. P., Brownstein, J. S., Hoen, A. G., ... & Hay, S. I. (2012). Refining the global spatial limits of dengue virus transmission by evidence-based consensus. PLoS Negl Trop Dis 6(8), e1760. https://doi.org/10.1371/journal.pntd.0001760
Castillo, J. A., Naranjo, J. S., Rojas, M., Castaño, D., & Velilla, P. A. (2019). Role of monocytes in the pathogenesis of dengue. Archivum Immunologiae et Therapiae Experimentalis, 67, 27-40. https://doi.org/10.1007/s00005-018-0525-7
Chaloemwong, J., Tantiworawit, A., Rattanathammethee, T., Hantrakool, S., Chai-Adisaksopha, C., Rattarittamrong, E., & Norasetthada, L. (2018). Useful clinical features and hematological parameters for the diagnosis of dengue infection in patients with acute febrile illness: a retrospective study. BMC Hematology, 18(1), 20. https://doi.org/10.1186/s12878-018-0116-1
Dash, M. K., Samal, S., Rout, S., Behera, C. K., Sahu, M. C., & Das, B. (2024). Immunomodulation in dengue: towards deciphering dengue severity markers. Cell Communication and Signalling, 22, 451. https://doi.org/10.1186/s12964-024-01779-4
Guzman, M. G., & Harris, E. (2015). Dengue. TheLancet (London, England), 385(9966), 453–465. https://doi.org/10.1016/S0140-6736(14)60572-9
Hakami, A., Tomehi, R., Irekeola, A. A., Dobie, G., Alasmari, S., Makkawi, M., ... & Alshehri, A. A. (2025). Hematological parameters in recent and past dengue infections in Jazan Province, Saudi Arabia. Saudi Medical Journal, 46(5), 515-521. https://doi.org/10.15537/smj.2025.46.5.20240879
Dengue, World Health Organization,21 August 2025
https://www.who.int/news-room/fact-sheets/detail/dengue-and-severe-dengue
Kalimuddin, S., Chia, P. Y., Low, J. G., & Ooi, E. E. (2025). Dengue and severe dengue. Clinical Microbiology Reviews, 38(4), e00244-24. https://doi.org/10.1128/cmr.00244-24
Kuberski, T. T., & Rosen, L. (1977). Identification of dengue viruses using complement fixing antigen produced in mosquitoes. American Journal of Tropical Medicine and Hygiene, 26(3), 538–543. https://doi.org/10.4269/ajtmh.1977.26.538
Lertjuthaporn, S., Keawvichit, R., Polsrila, K., Sukapirom, K., Chuansumrit, A., Chokephaibulkit, K., ... & Pattanapanyasat, K. (2021). Kinetic changes of peripheral blood monocyte subsets and expression of co-stimulatory molecules during acute dengue virus infection. Pathogens, 10(11), 1458. https://doi.org/10.3390/pathogens10111458
Munasinghe, D. R., & Rajasuriya, K. (1967). Hepatitis in dengue-fever. The Ceylon Medical Journal, 12(4), 222–223.
Nakase, T., Giovanetti, M., Obolski, U., & Lourenço, J. (2024). Population at risk of dengue virus transmission has increased due to coupled climate factors and population growth. Communications Earth & Environment, 5(1), 475. https://doi.org/10.1038/s43247-024-01639-6
Neto, R. J. P. Costa, D. M. N., & Junior, G B. S. (2025). Kidney Involvement in Arboviral Diseases: Chikungunya, Dengue, and Zika. In: Bezerra da Silva Junior, G., De Francesco Daher, E., Barros, E. (eds) Tropical Nephrology. Sustainable Development Goals Series. Springer, Cham. https://doi.org/10.1007/978-3-031-94777-3_14
Ngono, A. E., & Shresta, S. (2018). Immune response to dengue and Zika. Annual review of Immunology, 36, 279-308. https://doi.org/10.1146/annurev-immunol-042617-053142
Poottasane, N., Phornprasitsaeng, P., Onthong, Y., Sinthana, T., & Limvorapitak, W. (2023). Predictive score for dengue infection with complete blood count parameters, including the monocyte distribution width: a retrospective single-center derivation and validation study. The American Journal of Tropical Medicine and Hygiene, 109(4), 926-932. https://doi.org/10.4269/ajtmh.23-0104
Priyadarshi, M., Sikdar, S., & Brijwal, M. (2024). Immune response in dengue fever and clinical implications In Mosquito-Borne Tropical Diseases.https://doi.org/10.5772/intechopen.1006372
Raj, V. S., Katoch, V. M., & Ganguly, N. K. (2025). Deadly RNA Viruses: Diagnosis, Detection, and Mitigation of Epidemics and Pandemics. (1st ed.), CRC Press, 400 Pages. https://doi.org/10.1201/9781003132547
Rajpal, A., Hanumanthappa, M. K., Sethi, J., Ratho, R. K., Pannu, A. K., Rajendran, M., ... & Sharma, N. (2026). Incidence, Risk Factors and Outcomes of Renal Involvement in Patients with Dengue Viral Infection. Indian Journal of Nephrology, 36(1), 1. https://doi.org/10.25259/IJN_393_2024
Rao, A. A., U, R. R., Gosavi, S., & Menon, S. (2020). Dengue fever: prognostic insights from a complete blood count. Cureus, 12(11). https://doi.org/10.7759/cureus.11594
Rathore, A. P., & St. John, A. L. (2020). Cross-reactive immunity among flaviviruses. Frontiers in Immunology, 11, 334. https://doi.org/10.3389/fimmu.2020.00334
Roy, S. K., Ghosh, B., Chakraborty, A., Hazra, S., Goswami, B. K., & Bhattacharjee, S. (2025). Haematological parameters as predictors of severe dengue: A study from northern districts of West Bengal, India. Journal of Vector Borne Diseases, 62(2), 218-225. https://doi.org/10.4103/JVBD.JVBD_119_24
Sabrina, R. S. A., Azami, N. A. M., & Yap, W. B. (2025). Dengue and flavivirus co-infections: Challenges in diagnosis, treatment, and disease management. International Journal of Molecular Sciences, 26(14), 6609. https://doi.org/10.3390/ijms26146609
Sankaradoss, A. (2026). The Evolution of Dengue Virus in India. Annual Review of Virology, 13. https://doi.org/10.1146/annurev-virology-100424-122700
Sufi Aiman Sabrina, R., Muhammad Azami, N. A., & Yap, W. B. (2025). Dengue and flavivirus co-infections: Challenges in diagnosis, treatment, and disease management. International Journal of Molecular Sciences, 26(14), 6609.https://doi.org/10.3390/ijms26146609
Swamy, A. M., Mahesh, P. Y., & Rajashekar, S. T. (2021). Liver function in dengue and its correlation with disease severity: a retrospective cross-sectional observational study in a tertiary care center in Coastal India. The Pan African Medical Journal, 40, 261. https://doi.org/10.11604/pamj.2021.40.261.29795
Tun, M. M. N., Mutua, M. M., Inoue, S., Takamatsu, Y., Kaneko, S., Urano, T., ... & Morita, K. (2025). Molecular and serological evidence of chikungunya virus among dengue suspected patients in Sri Lanka. Journal of Infection and Public Health, 18(5), 102709. https://doi.org/10.1016/j.jiph.2025.102709
Wells, T. J., Esposito, T., Henderson, I. R., & Labzin, L. I. (2025). Mechanisms of antibody-dependent enhancement of infectious disease. Nature Reviews Immunology, 25(1), 6-21. https://doi.org/10.1038/s41577-024-01067-9
Wiwanitkit, S., & Wiwanitkit, V. (2017). Renal failure due to important arbovirus infection: A short summary. Saudi Journal of Kidney Diseases and Transplantation, 28(5), 1206-1208. https://doi.org/10.4103/1319-2442.215124
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Kumari, K., Angel, B., Angel, A., Chitransh, A. and Joshi, V. (2026) “Biochemical and Hematological Parameters among Patients of Mild and Severe Dengue: A Preliminary Study”, International Journal of Advancement in Life Sciences Research, 9(4), pp. 230-240. doi: https://doi.org/10.31632/ijalsr.2026.v09i04.015.
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