725. Complete Blood Count Values Vary in Degree of Change with Day of Fever in Children with Dengue Fever

Abstract

Background. Dengue fever (DF) is an acute viral disease which can lead to severe illness, including dengue hemorrhagic fever, marked by thrombocytopenia and hemolytic anemia, as well as end-organ damage. Despite the well-known presentation and prevalence, changes in hematologic markers across the DF course have not been well-described in children. We sought to investigate the association of clinical laboratory values over time with dengue disease progression and outcome in a pediatric population in the Dominican Republic. Methods. Pediatric participants were enrolled at Hospital Infantil Dr. Robert Reid Cabral in Santo Domingo, Dominican Republic, in a prospective, observational case-based study. Laboratory values, including complete blood count (CBC) indices and dengue titer results, were collected over the course of hospital stay. Using linear mixed models, we assessed whether 13 different CBC values and time trajectories differed by dengue status, including age and sex as covariates. To account for multiple testing, p < 0.0001). Those with DF had levels increasing more quickly for mean corpuscular hemoglobin concentration (MCHC), monocyte number, and white blood cell counts (p < 0.001). The direction of the change across time differed by DF status for mean corpuscular volume and red blood cell distribution width (RDW) (p < 0.0033). Conclusion. The trajectory of CBC measures differs between those with and without DF, despite similar clinical presentations. These laboratory differences may facilitate a better understanding of the clinical course of DF and may aid in earlier identification of DF in resource-limited settings.