Metabolic and cardiovascular comorbidities as predictors of severe dengue in Vietnamese adults: a retrospective study, 2022–2024

Objectives This study aimed to determine the prevalence of severe dengue and examine the associations between pre-existing comorbidities and disease severity. Methods This retrospective study examined patients with dengue fever who received inpatient treatment at a hospital in northern Vietnam between January 1, 2022, and December 30, 2024. Patients were categorized into 2 groups—severe dengue and non-severe dengue—based on the 2009 World Health Organization criteria. Multivariable logistic regression was performed to assess factors associated with severe dengue. Results Among 3,692 patients, the prevalence of severe dengue was 1.5%. Patients with any pre-existing comorbidity had higher odds of severe dengue compared to those without comorbidities (adjusted odds ratio [aOR], 2.06; 95% confidence interval [CI], 1.20–3.53). Having 2 or more comorbidities was also associated with higher odds of severe dengue (aOR, 2.26; 95% CI, 1.18–4.33). Among individual conditions, hyperlipidemia was associated with severe dengue (aOR, 2.32; 95% CI, 1.17–4.81). Certain combinations of comorbidities, including hypertension with hyperlipidemia (aOR, 2.88; 95% CI, 1.39–5.97), hypertension with cardiac disease (aOR, 4.39; 95% CI, 1.30–14.79), and hyperlipidemia with cardiac disease (aOR, 4.02; 95% CI, 1.19–13.53), were also associated with higher odds of severe dengue. Conclusion Pre-existing comorbidities, particularly cardiometabolic conditions, were associated with higher odds of severe dengue. Considering comorbidity profiles at hospital admission may help identify patients who require closer clinical monitoring.