Dengue fever in immunocompromised patients: A systematic review and meta-analysis

Objectives: Given the complex role of immunity in dengue severity, we aimed to review the clinical course of dengue infection in immunocompromised patients. Methods: We conducted a systematic review of studies reporting outcomes among immunocompromised patients with laboratory-confirmed dengue infec...

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Main Authors: Asma Sohail, Shannon Zhong, Phi-Yen Nguyen, Sarah L. McGuinness, Karin Leder
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:International Journal of Infectious Diseases
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Online Access:http://www.sciencedirect.com/science/article/pii/S1201971224003436
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author Asma Sohail
Shannon Zhong
Phi-Yen Nguyen
Sarah L. McGuinness
Karin Leder
author_facet Asma Sohail
Shannon Zhong
Phi-Yen Nguyen
Sarah L. McGuinness
Karin Leder
author_sort Asma Sohail
collection DOAJ
description Objectives: Given the complex role of immunity in dengue severity, we aimed to review the clinical course of dengue infection in immunocompromised patients. Methods: We conducted a systematic review of studies reporting outcomes among immunocompromised patients with laboratory-confirmed dengue infection. Meta-analysis using the Mantel-Haenszel method (fixed effects) was performed for studies with control groups. We registered the study with PROSPERO (No. CRD42021258930). Results: We included 115 studies. Among these, 30 studies compared immunocompromised (cases) and nonimmunocompromised (control) patients, focusing mainly on children (n = 22 studies) with malnutrition (n=18). Immunocompromised patients had a higher likelihood of dengue complications (OR 1.87; 95% CI: 1.04-3.35]) but a lower likelihood of severe dengue (OR 0.83; 95% CI: 0.69-1.00]. No significant difference in mortality was observed. In the 85 studies focused solely on immunocompromised patients, severe dengue and mortality rates were 9% and 4%, respectively, mostly among adult solid organ transplant recipients and those with inflammatory diseases. Immunosuppressive treatment alterations and temporary graft dysfunction were reported. Conclusion: Immunocompromised patients have an increased risk of dengue-related complications. However, definitive conclusions about the comparative severity of dengue across different immunocompromised patient groups are limited by a lack of robust data, highlighting the need for well-designed future studies.
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spelling doaj-art-16bf424c15334491aa5b17f177841f9a2025-08-20T02:49:05ZengElsevierInternational Journal of Infectious Diseases1201-97122024-12-0114910727210.1016/j.ijid.2024.107272Dengue fever in immunocompromised patients: A systematic review and meta-analysisAsma Sohail0Shannon Zhong1Phi-Yen Nguyen2Sarah L. McGuinness3Karin Leder4School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Infectious Diseases Department, Grampians Health Service, Ballarat, Victoria, Australia; Corresponding author: Asma Sohail, School of Public Health and Preventive Medicine, Monash University, Level 4, 553 St Kilda Road, VIC 3004, Australia.School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Alfred Health, Melbourne, Victoria, AustraliaSchool of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, AustraliaSchool of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Infectious Diseases Department, Alfred Health, Melbourne, Victoria, AustraliaSchool of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Victorian Infectious Diseases Service, Melbourne Health, Parkville, Victoria, AustraliaObjectives: Given the complex role of immunity in dengue severity, we aimed to review the clinical course of dengue infection in immunocompromised patients. Methods: We conducted a systematic review of studies reporting outcomes among immunocompromised patients with laboratory-confirmed dengue infection. Meta-analysis using the Mantel-Haenszel method (fixed effects) was performed for studies with control groups. We registered the study with PROSPERO (No. CRD42021258930). Results: We included 115 studies. Among these, 30 studies compared immunocompromised (cases) and nonimmunocompromised (control) patients, focusing mainly on children (n = 22 studies) with malnutrition (n=18). Immunocompromised patients had a higher likelihood of dengue complications (OR 1.87; 95% CI: 1.04-3.35]) but a lower likelihood of severe dengue (OR 0.83; 95% CI: 0.69-1.00]. No significant difference in mortality was observed. In the 85 studies focused solely on immunocompromised patients, severe dengue and mortality rates were 9% and 4%, respectively, mostly among adult solid organ transplant recipients and those with inflammatory diseases. Immunosuppressive treatment alterations and temporary graft dysfunction were reported. Conclusion: Immunocompromised patients have an increased risk of dengue-related complications. However, definitive conclusions about the comparative severity of dengue across different immunocompromised patient groups are limited by a lack of robust data, highlighting the need for well-designed future studies.http://www.sciencedirect.com/science/article/pii/S1201971224003436ImmunosuppressionImmunosuppressed hostClinical outcomesMeta-analysisVector borne diseaseArboviral disease
spellingShingle Asma Sohail
Shannon Zhong
Phi-Yen Nguyen
Sarah L. McGuinness
Karin Leder
Dengue fever in immunocompromised patients: A systematic review and meta-analysis
International Journal of Infectious Diseases
Immunosuppression
Immunosuppressed host
Clinical outcomes
Meta-analysis
Vector borne disease
Arboviral disease
title Dengue fever in immunocompromised patients: A systematic review and meta-analysis
title_full Dengue fever in immunocompromised patients: A systematic review and meta-analysis
title_fullStr Dengue fever in immunocompromised patients: A systematic review and meta-analysis
title_full_unstemmed Dengue fever in immunocompromised patients: A systematic review and meta-analysis
title_short Dengue fever in immunocompromised patients: A systematic review and meta-analysis
title_sort dengue fever in immunocompromised patients a systematic review and meta analysis
topic Immunosuppression
Immunosuppressed host
Clinical outcomes
Meta-analysis
Vector borne disease
Arboviral disease
url http://www.sciencedirect.com/science/article/pii/S1201971224003436
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AT sarahlmcguinness denguefeverinimmunocompromisedpatientsasystematicreviewandmetaanalysis
AT karinleder denguefeverinimmunocompromisedpatientsasystematicreviewandmetaanalysis