{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T19:21:53Z","timestamp":1790709713943,"version":"4.1.0"},"reference-count":18,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,6,3]],"date-time":"2024-06-03T00:00:00Z","timestamp":1717372800000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001349","name":"National Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001349","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    There is a lack of evidence on the optimal administration of intravenous (IV) fluids in hospitalized adult dengue patients without compensated and hypotensive shock. This study utilized a well\u2010established cohort of dengue patients to compare risks of progressing to severe dengue (SD) over time for patients who were administered IV fluid versus others who were not. We included adult patients (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20094781) who were hospitalized for dengue infection from 2005 to 2008. Cases were patients who developed SD (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009689) and controls were patients who did not up until discharge (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20094092). We estimated the hazard\u00a0ratios (HRs) and risk of SD over time between groups administered different volumes of IV fluids versus the no IV fluid comparison group using Cox models with time\u2010dependent covariates. The doubly\u2010robust estimation approach was used to control for the propensity of fluid administration given clinical characteristics of patients. Subgroup analyses by age, sex, and dengue warning signs before IV fluid administration were conducted. High (&gt;2000\u2009mL\/day) IV fluids volume was associated with a higher risk of development of SD for those who had warning signs (HR: 1.77 [1.05\u20132.97],\n                    <jats:italic>p<\/jats:italic>\n                    : 0.0713) and for those below 55 years old (HR: 1.53 [1.04\u20132.25],\n                    <jats:italic>p<\/jats:italic>\n                    : 0.0713). Low (&lt;1000\u2009mL\/day) IV fluids volume was protective against SD for patients without warning signs (HR: 0.757 [0.578\u20130.990],\n                    <jats:italic>p<\/jats:italic>\n                    : 0.0883), no lethargy (HR: 0.770 [0.600\u20130.998],\n                    <jats:italic>p<\/jats:italic>\n                    : 0.0847), and females (HR: 0.711 [0.516\u20130.980],\n                    <jats:italic>p<\/jats:italic>\n                    : 0.0804). Over the course of hospitalization, there were no significant differences in IV fluid administration and SD risk in most subgroups, except in those who experienced lethargy and were administered IV fluid volume or quantity. Administering high volumes of IV fluids may be associated with an increased risk of SD during hospitalization for adult dengue patients without shock. Judicious use of IV fluids as supportive therapy is warranted.\n                  <\/jats:p>","DOI":"10.1002\/jmv.29726","type":"journal-article","created":{"date-parts":[[2024,6,3]],"date-time":"2024-06-03T08:01:08Z","timestamp":1717401668000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Intravenous fluid therapy in hospitalized adult dengue patients without shock: Impact on subsequent severe dengue and potential adverse effects"],"prefix":"10.1002","volume":"96","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1440-6306","authenticated-orcid":false,"given":"Baihui","family":"Xu","sequence":"first","affiliation":[{"name":"Lee Kong Chian School of Medicine Nanyang Technological University  Singapore City Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pranav","family":"Tewari","sequence":"additional","affiliation":[{"name":"Lee Kong Chian School of Medicine Nanyang Technological University  Singapore City Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tun Linn","family":"Thein","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases National Centre for Infectious Diseases  Singapore City Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leo Yee","family":"Sin","sequence":"additional","affiliation":[{"name":"Lee Kong Chian School of Medicine Nanyang Technological University  Singapore City Singapore"},{"name":"Department of Infectious Diseases National Centre for Infectious Diseases  Singapore City Singapore"},{"name":"Department of Infectious Diseases Tan Tock Seng Hospital  Singapore City Singapore"},{"name":"Department of Medicine Yong Loo Lin School of Medicine National University of Singapore  Singapore City Singapore"},{"name":"Saw Swee Hock School of Public Health National University of Singapore  Singapore City Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David Chien Boon","family":"Lye","sequence":"additional","affiliation":[{"name":"Lee Kong Chian School of Medicine Nanyang Technological University  Singapore City Singapore"},{"name":"Department of Infectious Diseases National Centre for Infectious Diseases  Singapore City Singapore"},{"name":"Department of Infectious Diseases Tan Tock Seng Hospital  Singapore City Singapore"},{"name":"Department of Medicine Yong Loo Lin School of Medicine National University of Singapore  Singapore City Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Po Ying","family":"Chia","sequence":"additional","affiliation":[{"name":"Lee Kong Chian School of Medicine Nanyang Technological University  Singapore City Singapore"},{"name":"Department of Infectious Diseases National Centre for Infectious Diseases  Singapore City Singapore"},{"name":"Department of Infectious Diseases Tan Tock Seng Hospital  Singapore City Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jue Tao","family":"Lim","sequence":"additional","affiliation":[{"name":"Lee Kong Chian School of Medicine Nanyang Technological University  Singapore City Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,6,3]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"Dengue: Guidelines for Diagnosis, Treatment, Prevention and Control","author":"World Health Organization","year":"2009"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1086\/318479"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD000567"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.316.7136.961"},{"key":"e_1_2_11_6_1","volume-title":"Guide for Diagnosis, Treatment, and Control of Dengue Haemorrhagic Fever","author":"World Health Organization"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa044057"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0001397"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmii.2012.07.005"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0060946"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0235166"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01258-06"},{"key":"e_1_2_11_13_1","volume-title":"Dengue Haemorrhagic Fever: Diagnosis, Treatment, Prevention and Control","author":"World Health Organization","year":"1997"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1179\/2046904712Z.00000000051"},{"key":"e_1_2_11_15_1","volume-title":"Improvement of Case\u2010Management\u2014A Key Factor to Reduce Case\u2010Fatality Rate of Dengue Haemorrhagic Fever in Southern Viet Nam","author":"Hung NT","year":"2003"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.2149\/tmh.2011-S10"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid0908.020456"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0183544"},{"key":"e_1_2_11_19_1","unstructured":"Ministry of Health Singapore. Communicable disease surveillance in Singapore 2018.2018. Accessed October 30 2023.https:\/\/www.moh.gov.sg\/resources-statistics\/reports\/communicable-diseases-surveillance-in-singapore-2018"}],"container-title":["Journal of Medical Virology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jmv.29726","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T06:45:35Z","timestamp":1763707535000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jmv.29726"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6]]},"references-count":18,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,6]]}},"alternative-id":["10.1002\/jmv.29726"],"URL":"https:\/\/doi.org\/10.1002\/jmv.29726","archive":["Portico"],"relation":{},"ISSN":["0146-6615","1096-9071"],"issn-type":[{"value":"0146-6615","type":"print"},{"value":"1096-9071","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6]]},"assertion":[{"value":"2024-03-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-05-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-06-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e29726"}}