Chronic Complications Following Dengue Infection: A Scoping Review

Dengue virus infection has increased substantially in Latin America, prompting epidemiological alerts from regional health authorities in recent years. While most published research focuses on the acute phase, chronic multisystemic sequelae remain poorly characterized. This scoping review aimed to identify and describe chronic complications in adult patients following dengue infection, as reported in the available scientific literature. A scoping review was conducted following the PRISMA-ScR guidelines. A structured Population, Concept, Context (PCC) question guided searches of PubMed (National Library of Medicine, Bethesda, Maryland), Scopus (Elsevier, Amsterdam, the Netherlands), Google Scholar (Google, Mountain View, California), EMBASE (Elsevier, Amsterdam, the Netherlands), Cochrane Library (John Wiley & Sons, Hoboken, New Jersey), and LILACS (BIREME, São Paulo, Brazil), and gray literature from January 2005 to June 15, 2026. Articles were screened independently by eight reviewers using Rayyan; inter-rater reliability was assessed using Fleiss' kappa (κ = 0.81, 95% CI: 0.74-0.88), and disagreements were resolved by consensus. Of the 222 identified records, 62 studies met the inclusion criteria after deduplication and full-text screening. Neurological complications were the most frequently represented category among the included publications (30.6%, n = 19), followed by ophthalmological (19.4%, n = 12), heterogeneous persistent symptoms (12.9%, n = 8), fatigue (9.7%, n = 6), multisystemic (9.7%, n = 6), psychiatric (9.7%, n = 6), cardiological (4.8%, n = 3), and immunological (3.2%, n = 2) complications. These proportions reflect the distribution of the published literature rather than the clinical prevalence of complications among dengue patients, given that approximately one-third of the included studies were case reports or case series. The evidence base includes the largest population-based cohort of post-acute dengue sequelae to date (n = 55,870, Singapore), a two-year disability-adjusted life-year (DALY) burden analysis from the same registry, the first systematic review of dengue-associated Guillain-Barré syndrome, the first reported case of chronic dengue encephalitis with brain-tissue DENV RNA confirmed by metagenomic sequencing, and two narrative reviews that substantially expanded the evidence base on psychiatric sequelae. Dengue infection is associated with a broad and heterogeneous spectrum of chronic complications affecting multiple organ systems, including elevated post-acute cardiovascular, neuropsychiatric, and autoimmune risks, as well as a measurable disease and healthcare cost burden. The absence of a consistent relationship between acute severity and chronic outcomes supports structured, evidence-based, long-term post-dengue follow-up, particularly for patients with persistent symptoms or clinically relevant risk factors and for underrepresented Latin American populations.