Dengue in older inpatients in the post-COVID-19 Period: a case series from a North Indian tertiary center

Studies on dengue in older patients are scarce from India. The patterns of dengue in the post-COVID-19 period have been poorly studied globally. Our case series describes the patterns and outcomes of dengue in inpatients of the geriatric unit of a tertiary university hospital in North India during the period of August -December 2023. Twenty-four patients were diagnosed with dengue out of 182 admissions during the study period (13.2 %). The median (Q1-Q3) age of patients was 67.5 (64.75-75) years. Fever was present in all except one patient (95.8 %). Weakness, vomiting, dyspnea, and altered sensorium occurred in 41.7 %, 37.5 %, 29.2 %, and 20.8 %, respectively. Hyponatremia, thrombocytopenia, and anemia were observed in 58.3 %, 45.8 %, and 25 % of cases, and nearly one-third developed hepatitis. Leucopenia rates were relatively low. Dengue was severe in two-thirds, and acute kidney injury was the commonest complication. Three fatalities were observed<b>.</b> In summary, many older patients had atypical presentations of dengue, and the disease was severe in a significant proportion. Larger multi-centric surveillance studies with the inclusion of immunogenic correlates of COVID-19 are needed to understand its effects if any on the age and region-specific variations of dengue in the elderly.