Title : Association between obesity and dengue severity in a tertiary pediatric hospital in the Philippines
Abstract:
Dengue infection is currently one of the most important mosquito-borne viral diseases in the tropical parts of the world (WHO, 1999).1 When it comes to viral infections like Dengue Fever, nutritional status is a key factor to immune functions since it has an influence on genomics and metabolisms. In obese patients, the adipose tissue in overweight could stimulate more inflammatory mediators, which lead to increased capillary permeability and plasma leakage.2 Early identification of factors associated with severe dengue is significant to improve patient outcomes and decrease mortality. The objective of this study was to assess associations between obesity and dengue severity among children in a Tertiary Pediatric Hospital from January to December 2023. Subjects were all children who are less than 18 years with acute dengue infection confirmed by positive NS1 or IgM who were admitted at the National Children’s Hospital from January to December 2023 were included in the study.
Most of the patients with severe dengue had normal BMI and were from the age group 11-18 years old residing in urban areas with equal sex distribution. This study did not find a significant association between obesity and severe dengue in contrast to the theory that obese children are expected to have a stronger immune response. At present, obesity is considered a low-grade inflammation with excess production of IL-1β, Il-6 and TNF-α3 and chronic exposure to pro-inflammatory cytokines may desensitize immune cells to inflammatory responses during the actual infection.4 This study has several limitations inherent to the nature of a single-center retrospective cross-sectional study and this group may not adequately represent the entire population which may raise the possibility of selection bias. Larger prospective studies on multiple institutions with longer duration may be done to more accurately assess the association between obesity and dengue severity.
