SUPAR as a Predictive Biomarker for Severe Dengue Infection in Hospitalized Children: A Diagnostic Laboratory Approach

Abstract

Background: Dengue infection remains a major public health issue in Indonesia, particularly affecting children who are more vulnerable to severe outcomes. Identifying reliable biomarkers for predicting disease severity is crucial for improving clinical management and reducing mortality rates. The soluble urokinase-type plasminogen activator receptor (suPAR) has emerged as a promising biomarker for systemic infections due to its stable plasma levels and minimal circadian variation. This study investigates the potential of suPAR as a predictive biomarker for severe Dengue infection in hospitalized pediatric patients.
Objective: To evaluate plasma suPAR levels in children with Dengue infection, assess its correlation with disease severity, and determine its predictive value for identifying patients at higher risk of severe infection.
Methods: A cross-sectional study was conducted with 52 pediatric patients diagnosed with Dengue infection. Plasma suPAR levels were measured using enzyme-linked immunosorbent assay (ELISA). Patients were categorized based on clinical severity into Dengue Fever/Dengue Hemorrhagic Fever (DHF) Grade 1, DHF Grades 2–4, and further classified into Shock and Non-Shock groups. Statistical analyses were performed to evaluate correlations and odds ratios (OR) for severe Dengue prediction.
Results: Mean suPAR levels significantly differed between DHF Grade 1 and DHF Grade 2 (p = 0.003), and between DHF Grade 1 and DHF Grade 4 (p = 0.047). suPAR levels demonstrated a weak but significant correlation with overall disease severity (r = 0.350; p = 0.011). The odds ratio (OR) for developing DHF Grades 2–4 compared to DHF Grade 1 was 6.5 (p = 0.001) with a suPAR cutoff level > 6.25 ng/mL. However, no significant difference in suPAR levels was observed between Shock and Non-Shock groups.
Conclusion: suPAR shows potential as a predictive biomarker for severe Dengue infection in children, offering valuable diagnostic insights that could support early clinical interventions. Its use in laboratory diagnostics may enhance the ability to identify children at risk of severe outcomes, contributing to more effective patient management and improved prognostic outcomes in pediatric Dengue cases.