Abstract
INTRODUCTION: Dengue fever poses a significant public health challenge in Nepal, with increasing severe cases requiring intensive care. Limited data exist on the clinical profile and outcomes of critically ill dengue patients in resource-limited settings. This study is aimed to characterize the clinical features, outcomes and complications of dengue patients admitted to a tertiary Intensive care unit in Nepal. METHODS: A prospective observational study was conducted at from August to September 2024 after ethical approval. We enrolled 104 serologically confirmed dengue patients (aged ≥16 years) admitted to the Medical Intensive care unit. Exclusion criteria included co-infections with other tropical diseases. Data on demographics, clinical presentation, laboratory parameters (including platelet counts, liver enzymes), organ dysfunction (SOFA score), and outcomes were collected. Descriptive data analysis was used to report frequency, proportion, measure of central tendency and measure of dispersion based on nature of data. RESULTS: The cohort (median age 41 years, 54.8% male) exhibited severe manifestations: thrombocytopenia (median platelets count 49,000/μL; IQR: 30,250-85,000 per μL), hepatic injury 86 (82.7%); median AST 176.5 U/L, ALT 208.5 U/L), and moderate organ dysfunction (median SOFA score 4). Hypertension 27 (25.96%) and diabetes 23 (22.12%) were common comorbidities. Despite 22 (21.2%) developing multi-organ dysfunction syndrome, mortality was remarkably low 1 (0.96%). CONCLUSIONS: Dengue fever cases peak during the month of August and September in endemic areas (Chitwan and surrounding district). Mortality could be reduced in severe dengue with appropriate critical care, highlighting the need to strengthen ICU capacity in endemic regions.