Febrile Phase Soluble Urokinase Plasminogen Activator Receptor and Olfactomedin 4 as Prognostic Biomarkers for Severe Dengue in Adults.

This article focuses on evaluating plasma biomarkers as prognostic tools for severe dengue (SD) in an adult population. In a prospective study of 99 adults with varying dengue severities and 30 controls, soluble urokinase plasminogen activator receptor (suPAR) levels were significantly elevated in severe dengue patients across febrile, critical, and recovery phases, with suPAR showing strong predictive ability for SD in the febrile phase (area under the receiver operating curve [AUROC] 0.82). Olfactomedin 4 was elevated in dengue patients but was only a modest predictor of severity, while mast cell mediators chymase and tryptase showed no significant differences or prognostic value. The findings suggest that suPAR may serve as a reliable early biomarker for identifying adults at risk of severe dengue, potentially aiding clinical management and resource allocation during outbreaks.