Association Between Platelet Count and Liver Enzymes in Critical Phase Dengue Patients: A Cross-Sectional Study

Authors

  • Maria M Barek Teluma Department of Medical Laboratory Technology, Politeknik Sandi Karsa, South Sulawesi, Indonesia
  • Nur Ismi Department of Medical Laboratory Technology, Politeknik Sandi Karsa, South Sulawesi, Indonesia
  • Andi Heriadi Palloge Department of Medical Laboratory Technology, Politeknik Sandi Karsa, South Sulawesi, Indonesia

DOI:

https://doi.org/10.61099/jih.v2i2.252

Keywords:

Alanine Transaminase, Aspartate Aminotransferases, Dengue, Liver Diseases, Thrombocytopenia

Abstract

Introduction: Dengue infection remains a major cause of hospitalization in tropical regions, particularly during the critical phase when plasma leakage, thrombocytopenia, and organ involvement increase the risk of severe complications. Hepatic dysfunction, reflected by elevated aspartate aminotransferase (AST) and alanine aminotransferase (ALT), frequently accompanies hematologic deterioration. However, the phase-specific association between platelet count and liver enzyme elevation remains insufficiently characterized. This study aimed to determine the association between platelet count and AST and ALT levels among patients in the critical phase of dengue infection.

Research Methodology: An analytic observational study with a cross-sectional design was conducted at Dr. TC Hillers Regional General Hospital, East Nusa Tenggara, Indonesia, between January and December 2025. A total of 68 patients meeting the WHO criteria for critical-phase dengue were included through consecutive sampling. Platelet count, AST, and ALT levels were extracted from medical records. Data distribution was assessed using the Shapiro–Wilk test. Pearson or Spearman correlation analysis was applied as appropriate. Statistical significance was set at α = 0.05.

Results: The mean platelet count was 72.4 ± 28.7 ×10³/µL. Mean AST and ALT levels were 148.6 ± 64.2 U/L and 96.3 ± 41.8 U/L, respectively. Elevated AST was observed in 95.6% of patients, and elevated ALT in 85.3%. A significant negative correlation was found between platelet count and AST (r = −0.412, p = 0.001) and between platelet count and ALT (r = −0.356, p = 0.003).

Conclusion: Platelet decline is significantly associated with hepatic enzyme elevation during the critical phase of dengue infection. Integrated monitoring of platelet counts and transaminases may enhance risk stratification and support early identification of severe systemic involvement in endemic hospital settings.

Downloads

Download data is not yet available.

References

[1] A. Dinkar and J. Singh, “Dengue serotypes and their severity correlation: A hospital-based observational study,” Enfermedades Infecc. y Microbiol. Clin. (English ed.), vol. 44, no. 2, p. 503074, 2026, doi: https://doi.org/10.1016/j.eimce.2026.503074.

[2] A. Dinkar and J. Singh, “Dengue serotypes and their severity correlation: A hospital-based observational study,” Enferm. Infecc. Microbiol. Clin., vol. 44, no. 2, p. 503074, 2026, doi: https://doi.org/10.1016/j.eimc.2025.503074.

[3] L. Guo et al., “Platelet dynamics and thrombocytopenia in dengue fever: A prospective cohort study from Shenzhen, China,” New Microbes New Infect., vol. 67, p. 101624, 2025, doi: https://doi.org/10.1016/j.nmni.2025.101624.

[4] Y.-P. Hung et al., “Incidence and co-infection with COVID-19 of dengue during the COVID-19 pandemic,” J. Formos. Med. Assoc., vol. 124, no. 3, pp. 206–211, 2025, doi: https://doi.org/10.1016/j.jfma.2024.06.007.

[5] A. R. Jean Pierre et al., “Clinical correlations of plasma sphingosine-1-phosphate and sphingolipid key enzymes in severe dengue using laboratory and machine learning approach,” Clin. Chim. Acta, vol. 574, p. 120335, 2025, doi: https://doi.org/10.1016/j.cca.2025.120335.

[6] K. Khare et al., “Inter-host diversity associated with age, sex, and menstrual cycle modulates clinical manifestations in DENV-2 patients,” iScience, vol. 28, no. 5, p. 112478, 2025, doi: https://doi.org/10.1016/j.isci.2025.112478.

[7] K. Kumar, H. Shaileshbhai Shah, N. N. Mehta, A. Kumar Jain, V. Kumar Mahala, and V. Anand Saraswat, “Clinical Profile and Prognostic Predictors in Hepatitis A Virus–Induced Acute Liver Failure,” J. Clin. Exp. Hepatol., vol. 16, no. 3, p. 103471, 2026, doi: https://doi.org/10.1016/j.jceh.2026.103471.

[8] V. Kumar and J. H. Stewart IV, “Platelet’s plea to Immunologists: Please do not forget me,” Int. Immunopharmacol., vol. 143, p. 113599, 2024, doi: https://doi.org/10.1016/j.intimp.2024.113599.

[9] V. Li et al., “Soluble tumour necrosis factor receptor 1 predicts hospitalization in children and young adults with dengue virus infection in the Philippines,” Cytokine, vol. 190, p. 156911, 2025, doi: https://doi.org/10.1016/j.cyto.2025.156911.

[10] U. Limothai, N. Srisawat, and D. A. Haake, “Early diagnosis and treatment of leptospirosis: Optimizing clinical outcomes,” J. Infect., vol. 92, no. 2, p. 106675, 2026, doi: https://doi.org/10.1016/j.jinf.2025.106675.

[11] A. K. Manggala, J. U. Aulya, J. K. Fajar, and D. K. Wati, “The risk factors of dengue shock syndrome among Indonesian children: A systematic review and meta-analysis,” Clin. Epidemiol. Glob. Heal., vol. 34, p. 102095, 2025, doi: https://doi.org/10.1016/j.cegh.2025.102095.

[12] V. Mariappan et al., “Increased shedding of PECAM-1 associated with elevated serum MMP-14 levels as new blood indicators of dengue disease manifestation,” Infect. Dis. Now, vol. 54, no. 7, p. 104964, 2024, doi: https://doi.org/10.1016/j.idnow.2024.104964.

[13] C. Mettananda et al., “The role of serum ferritin in predicting plasma leakage among adults and children with dengue in Sri Lanka: a multicentre, prospective cohort study,” Lancet Reg. Heal. - Southeast Asia, vol. 37, p. 100606, 2025, doi: https://doi.org/10.1016/j.lansea.2025.100606.

[14] N. M. Nam et al., “Human parvovirus B19 infection in dengue patients and potential association with disease progression and clinical outcomes,” IJID Reg., vol. 17, p. 100775, 2025, doi: https://doi.org/10.1016/j.ijregi.2025.100775.

[15] F. Zeb et al., “Age, gender, and infectious status-wise assessments of hematological parameters among patients with dengue infection,” Heliyon, vol. 10, no. 13, p. e34053, 2024, doi: https://doi.org/10.1016/j.heliyon.2024.e34053.

[16] M. A. Niriella, R. A. Premaratna, S. Hathurusinghe, R. Premaratna, A. S. Dassanayake, and H. J. de Silva, “Liver involvement in dengue virus infection: a narrative review,” J. Clin. Virol. Plus, vol. 6, no. 2, p. 100247, 2026, doi: https://doi.org/10.1016/j.jcvp.2026.100247.

[17] W.-H. Wang et al., “Dengue virus modulates the fibrinolytic system to drive vascular leakage and serves as a therapeutic target for tranexamic acid,” Eur. J. Pharmacol., vol. 1015, p. 178553, 2026, doi: https://doi.org/10.1016/j.ejphar.2026.178553.

[18] A. M. Tejo, D. T. Hamasaki, L. M. Menezes, and Y.-L. Ho, “Severe dengue in the intensive care unit,” J. Intensive Med., vol. 4, no. 1, pp. 16–33, 2024, doi: https://doi.org/10.1016/j.jointm.2023.07.007.

[19] G. Paz-Bailey, L. E. Adams, J. Deen, K. B. Anderson, and L. C. Katzelnick, “Dengue,” Lancet, vol. 403, no. 10427, pp. 667–682, 2024, doi: https://doi.org/10.1016/S0140-6736(23)02576-X.

[20] Z.-S. Yang et al., “Dengue virus infection: A systematic review of pathogenesis, diagnosis and management,” J. Infect. Public Health, vol. 18, no. 12, p. 102982, 2025, doi: https://doi.org/10.1016/j.jiph.2025.102982.

[21] I. T. Peres et al., “Clinical characteristics, complications and outcomes of critically ill patients with Dengue in Brazil, 2012-2024: A nationwide, multicenter cohort study,” Int. J. Infect. Dis., vol. 159, p. 108023, 2025, doi: https://doi.org/10.1016/j.ijid.2025.108023.

[22] S. Sann et al., “Increased frequencies of highly activated regulatory T cells skewed to a T helper 1-like phenotype with reduced suppressive capacity in dengue patients,” MBio, vol. 15, no. 6, 2024, doi: https://doi.org/10.1128/mbio.00063-24.

[23] S. Shamsabadi, A. Dayhimi, M. Salari, and H. Pazoki-Toroudi, “Evaluating antiviral candidates for dengue virus infection: A review,” Parasite Epidemiol. Control, p. e00483, 2026, doi: https://doi.org/10.1016/j.parepi.2026.e00483.

[24] S. Suprapto, “Relationship between knowledge level and contraceptive compliance among family planning acceptors: A Cross-Sectional Study,” J. Interdiscip. Heal., vol. 2, no. 1, pp. 27–34, Jan. 2026, doi: https://doi.org/10.61099/jih.v2i1.175.

[25] N. Singh and S. S. Yadav, “Anti-dengue therapeutic potential of Tinospora cordifolia and its bioactives,” J. Ethnopharmacol., vol. 330, p. 118242, 2024, doi: https://doi.org/10.1016/j.jep.2024.118242.

[26] C. Struyfs et al., “Quantifying temporal differences in the induction of interferon-mediated signalling observed in a dengue virus 1 human infection model: insights from longitudinal proteome analysis,” eBioMedicine, vol. 115, p. 105728, 2025, doi: https://doi.org/10.1016/j.ebiom.2025.105728.

Downloads

Published

2026-03-31

How to Cite

Maria M Barek Teluma, Nur Ismi, & Andi Heriadi Palloge. (2026). Association Between Platelet Count and Liver Enzymes in Critical Phase Dengue Patients: A Cross-Sectional Study. Journal Interdisciplinary Health, 2(2), 63–71. https://doi.org/10.61099/jih.v2i2.252

Citation Check

Similar Articles

You may also start an advanced similarity search for this article.