Evidence supporting the correlation between aging and dengue severity: A retrospective analysis on the 2010 dengue outbreak in Brazil

Abstract

Objective: The aim of this study is to explore the role of aging and non-communicable diseases (NCDs) as potential risk factors for severe clinical manifestations of dengue. This investigation was conducted within a cohort of patients from the 2010 epidemic in Belo Horizonte, Brazil. Methods: A total of 144 subjects diagnosed with dengue were categorized into two groups, representing the early and late (critical) stages of the disease. Further stratification was performed based on age, distinguishing between young and aged subjects. NCD subjects were also divided into young and aged groups. The symptomatology, previous clinical history, age, and presence of NCDs were inquired. Blood samples were collected for the analysis of platelet, soluble tumor necrosis factor receptor 1 (sTNFR1), and aspartate aminotransferase (AST) levels. The Mann-Whitney test was explored for the comparison of two groups, whereas the Kruskal-Wallis test was used for the analysis of differences among the multiple groups. Categorical variables were examined by Chi-square test. Correlation assessments were conducted using binary logic regression analysis with a 95% confidence interval. P<0.05 was considered statistically significant. Results: Compared to the younger subjects with NCDs, aged subjects exhibited a more severe form of dengue during the critical phase. The presence of NCDs was not associated with a worse dengue outcome in younger individuals, suggesting that aging itself maybe an important contributor to the severity of dengue. Conclusions: In the studied cohort, we emphasize that aging is a significant factor associated with severe manifestations of dengue. While we do not discard the potential role of NCDs in exacerbating disease progression, it may be more prominently impact the aged groups.