Evaluation of body weight/body mass index as a predictor of dengue severity in children

Higher body mass index (BMI) is a risk factor for many non-communicable diseases and certain infectious diseases. Very less evidence is available that links body mass with dengue severity especially in children. The aim of this study was to evaluate any association between body weight/body mass index of children with severity of dengue illness. A retrospective, medical-records based observational study was conducted on 100 dengue-infected children in the age group of 2-15 years between August and October 2023. Dengue serology, complete blood picture, liver enzymes and coagulation profile were noted along with recording of anthropometric parameters like height and weight at the time of admission. Based on clinical presentation, patients were classified as severe and non-severe dengue. Most of the admitted dengue infected children belonged to underweight (67%) and normal weight (27%) category. The patients were divided into 2 groups: Group 1 included patients in the age group of 2-5 years where the independent variable considered was z-score for weight-for-age and Group 2 included patients between >5-15 years where z-score for BMI-for-age was taken as independent variable. Binomial logistic regression analysis was done to correctly classify the cases as non-severe and severe based on z-scores of weight-for-age / BMI-for-age (independent variable) of the effected children which was statistically significant in group 2 (p=0.000). The model correctly classified 61.8% of cases in group 1 and 86.4% of cases in group 2. Though the majority of cases were in underweight or normal weight category, the results indicate that those with higher weight and BMI for their age and gender are more likely to develop severe dengue infection.