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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Elsevier
2024-12-01
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| 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. |
| format | Article |
| id | doaj-art-16bf424c15334491aa5b17f177841f9a |
| institution | DOAJ |
| issn | 1201-9712 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| 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 |
| work_keys_str_mv | AT asmasohail denguefeverinimmunocompromisedpatientsasystematicreviewandmetaanalysis AT shannonzhong denguefeverinimmunocompromisedpatientsasystematicreviewandmetaanalysis AT phiyennguyen denguefeverinimmunocompromisedpatientsasystematicreviewandmetaanalysis AT sarahlmcguinness denguefeverinimmunocompromisedpatientsasystematicreviewandmetaanalysis AT karinleder denguefeverinimmunocompromisedpatientsasystematicreviewandmetaanalysis |