INCIDENCE OF CARDIAC MANIFESTATIONS IN CHILDREN AND ADULTS WITH DENGUE FEVER (META-ANALYSIS)

Abstract

More and more research indicates that dengue fever, a mosquito-borne viral spread disease, can affect multiple organ systems including the heart. Historically infrequent, cardiac manifestations in dengue have now been more frequently reported, particularly in children and those with severe disease. These complications can have significant impact on patient outcomes, particularly in resource limited high burden settings. The purpose of this meta-analysis is to determine the pooled incidence and the spectrum of cardiac manifestations in pediatric and adult patients with confirmed dengue infection, as well as diagnostic modalities and clinical outcomes. A systematic search was performed in PubMed, Google Scholar, LILACS and ResearchGate for studies published from 2016 to 2023. Studies and reviews which reported cardiac involvement due to dengue were included. We extracted data regarding ECG abnormalities, echocardiographic findings, cardiac biomarker elevations and clinically diagnosed myocarditis. Newcastle-Ottawa Scale (NOS), AMSTAR 2 were used to study quality. Subgroup analyses by age and disease severity were done and a random effects meta analysis was performed. Seven studies comprising 860 patients were included. A total of 38.4% of patients had cardiac manifestations overall. Specifically, ECG abnormalities were seen in 41.6% of cases, elevated cardiac biomarkers in 31.9%, and echocardiographic changes seen in 28.2%. In 18.9% of cases, it was diagnosed as myocarditis. Notably higher ECG and echocardiographic abnormalities were seen in pediatric populations. Dengue involvement of the cardia is much more common than previously recognized; nearly 4 in 10 patients show some abnormality of the cardia. In endemic regions, early identification and monitoring of these complications through standardized diagnostic tools is important to improve its outcomes.