Evaluation of Neutrophil-lymphocyte Ratio as a Predictor of Complications in Dengue Infection

Abstract Introduction: Dengue is an endemic infection in Bangladesh with frequent outbreaks. Severe dengue including dengue shock syndrome (DSS), severe haemorrhage and expanded dengue syndrome (EDS), is the major contributor of morbidity and mortality in dengue infection. This study aimed to assess the association of neutrophil-lymphocyte ratio (NLR) with severe dengue, DHF, DSS, severe haemorrhage and EDS in dengue fever. Methods: This prospective study was conducted on 250 randomly selected dengue patients admitted under the Department of Medicine in Shaheed Monsur Ali Medical College Hospital, Dhaka, Bangladesh from July to December 2023. The study participants were divided into two groups – with NLR≥2 and NLR<2, on the third day of fever. Frequencies severe dengue, dengue haemorrhagic fever (DHF), DSS, severe haemorrhage and EDS were compared between the two groups. Results: NLR ≥2 on the third day of fever was associated with a statistically significant higher frequency of DHF, DSS, EDS and severe dengue. Conclusion: NLR can be used as a predictor of complications in dengue infection. Dengue patients with NLR ≥2 on the third day of fever possess a higher risk of developing complications, and hence need close monitoring.