A Study of Serum Lipid Profile Changes in Children with Dengue Haemorrhagic Fever and its Correlation with Severity in a Tertiary Care Hospital

Abstract

Introduction: Dengue Virus (DENV) infection now remains as the most rapidly spreading viral disease worldwide. Lower lipid level occurs in critically ill patients with DENV infection and is postulated as an independent predictor of the clinical outcome. Aim: To find the correlation between serum lipid levels and severity in children admitted with various grades of Dengue Haemorrhagic Fever (DHF) and secondarily to correlate serum lipid levels with factors like platelet count and duration of hospital stay. Materials and Methods: This was a prospective descriptive study done in the Paediatric ward from October 2019 to December 2019. Febrile Children with a platelet count of less than 1 lakh/cu.mm and positive for DENV IgM antibodies by Enzyme Linked Immuno Sorbent Assay (ELISA) formed the study group. Demographic details, number of days of fever on admission, duration of stay in hospital and severity grading of DENV infection as per the National guidelines were collected. These children were evaluated with Complete Blood Counts (CBC), fasting lipid profile, X-ray chest and ultrasound abdomen. Mean and standard deviation was used for categorical variables. Chi-square test was used to assess the strength of association between lipids and severity of DENV infections. Pearson correlation coefficient was used to assess R value between length of stay and serum lipid levels. Results: The Total Cholesterol, Low Density Lipoprotein (LDL), Triglyceride and Very Low Density Lipoprotein (VLDL) showed a simple linear decline as the severity grade advanced from grade I to grade IV. However, statistical significance was found only for total cholesterol and LDL with p-values of 0.046 and 0.041 respectively. The distribution of High Density Lipoprotein (HDL) across the grades of severity did not follow any pattern and was randomly distributed. On analysis of Pearson correlation between number of days of hospital stay and lipid profile, statistical significance was observed for LDL alone (p=0.023). Conclusion: The serum levels of total cholesterol and LDL were significantly reduced in severe grades of DHF. Serum levels of total cholesterol and LDL can be used as an economical surrogate marker to predict the severity of DHF at the time of admission.