Serum Albumin Levels in Patients with Dengue Fever – A Longitudinal Study

Abstract

Background and Objectives: Dengue is an arboviral disease that is a major public health threat globally. In the past 50 years, the incidence of dengue has increased about 30-fold. Clinical manifestations may range from asymptomatic patients to dengue shock syndrome. It is very important to know early, which patient will go on to develop complications for planning management. Like any other disease, dengue also has various biomarkers which are used to find out dengue infection and severity of dengue infection. Serum albumin is a negative acute-phase reactant whose level decreases during many infections. Serum albumin was found to be an independent factor associated with severe dengue and dengue mortality in various studies. The aim of this study is to compare serum albumin levels among severe and non-severe cases of dengue and to find any association.
Materials and Methods: This study was done on 120 dengue patients admitted in Government Medical College Ernakulam from January 2017 to December 2017. The clinical features and investigations results were noted. Serum albumin was done on the day of admission and the 3rd day of admission. Patients were classified into mild, moderate, and severe based on the severity of dengue. Serum albumin levels were compared with the different severity groups.
Results and Discussion: Of the 120 patients studied, 84 were male and 36 were female. The mean serum albumin of dengue patients on the day of admission was 3.61 g/dl and on the 3rd day of admission was 3.48 g/dl. The mean albumin on the day of admission was 3.71 g/dl, 3.60 g/dl, and 3.34 g/dl for mild, moderate, and severe dengue, respectively (P = 0.005). The mean albumin on the 3rd day of admission was 3.62 g/dl, 3.47 g/dl, and 3.19 g/dl for mild, moderate, and severe dengue patients, respectively (P = 0.001). As the severity of dengue increases, the mean day 1 and day 3 albumin levels decrease, which is statistically significant. Hypoalbuminemia (<3.5 g/dl) was seen on day 1 in 34.8%, 34%, and 57.1% among mild, moderate, and severe dengue patients, respectively (P = 0.148). There was no significant association of hypoalbuminemia on day 1 with the severity of dengue. Hypoalbuminemia was seen on day 3 in 26.1%, 47.2%, and 81% of mild, moderate, and severe dengue patients. There is a significant association between hypoalbuminemia on day 3 and severity of dengue. On 3rd day of admission, hypoalbuminemia was seen more as the severity of dengue increased.
Conclusions: As the severity of dengue increased, there was a fall in serum albumin levels and it was statistically significant. Serum albumin can be used as a prognostic marker for dengue.