Serum Aminotransferase Levels as a Marker in Assessment of Severity of Dengue Fever in Adult Patients- A Cross-sectional Study

Abstract

Introduction: Dengue Fever (DF) is the most common rapidly spreading mosquito-borne arboviral disease with a wide clinical spectrum that includes both severe and nonsevere clinical manifestations. Most patients with DF have liver involvement in the form of elevated serum Aminotransferase (AST). Severity of the disease is more in patients with elevated serum ASTs. Hence, this study was taken-up to assess the correlation with the elevated serum ASTs and severity of the disease. Aim: To measure and associate the serum AST levels as a marker in assessing severity of DF in adults. Materials and Methods: The cross-sectional study was conducted on 100 patients of DF admitted to General Medicine wards from May 2019 to April 2020 in Hassan Institute of Medical Sciences and hospital, Hassan, Karnataka, India. Serum AST levels were estimated at admission, on the day of discharge of the patient and correlated to prognosis of patient in DF. A pre-determined proforma was used to record the details of history, physical examination and investigation and results were recorded in a Microsoft excel master chart. Statistical analysis was done using Statistical Package for Social Sciences (SPSS) software, version 20.0, ANOVA and student t-test were used for calculation of significance in all parameters within the groups while Fischer’s-exact test was used to compare the significance between the groups. The p-value <0.05 was to be considered level of significance. Results: In this study, 100 (mean age: 31.65±12.08 years) patients of dengue Nonstructural protein 1/Immunoglobulin M (NS1/IgM) positive patients were studied. Out of this 60% NS1 Antigen (Ag), 22% NS1 Ag and IgM Antibody (Ab) and 18% were IgM Ab positive. 63 were males and 37 were females. AST/SGOT values were on day 1 was 203.76±360.87 U/L and on day of discharge was 55.96±31.76 U/L (p-value<0.001). And ALT/SGPT on day 1 was 109.63±146.01 U/L and on day od discharge was 41.05±20.78 U/L (p-value <0.001). Indicating dengue patients had raised AST/SGOT values on day 1 as compared to day of discharge. There was a significant difference (p-value <0.001) found on day 1 and at the time of discharge. Conclusion: Hepatic involvement, characterised by elevation of liver enzymes, is very common finding in Dengue Fever. Serum Aminotranferase (AST) levels are elevated more as compared to serum Alanine aminotransferase (ALT) . The present study found significant association of serum AST levels with the hospital stay and prognosis of the patient. Hence, serum AST levels are mandatory in DF to look for complications and it is of prognostic value.