{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T15:21:09Z","timestamp":1779895269990,"version":"3.53.1"},"reference-count":22,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,2,27]],"date-time":"2023-02-27T00:00:00Z","timestamp":1677456000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ratchadapiseksompotch Fund, Faculty of Medicine, Chulalongkorn University","award":["64\/013"],"award-info":[{"award-number":["64\/013"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>Dengue infection presents a wide range of clinical symptoms. Serum cortisol is known as a severity predictor of serious infection but is not yet clearly understood in dengue infection. We aimed to investigate the pattern of cortisol response after dengue infection and evaluate the possibility of using serum cortisol as the biomarker to predict the severity of dengue infection. This prospective study was conducted in Thailand during 2018. Serum cortisol and other laboratory tests were collected at four time points: day 1 at hospital admission, day 3, day of defervescence (DFV) (4\u20137 days post-fever onset), and day of discharge (DC). The study recruited 265 patients (median age (IQR) 17 (13, 27.5)). Approximately 10% presented severe dengue infection. Serum cortisol levels were highest on the day of admission and day 3. The best cut-off value of serum cortisol level for predicting severe dengue was 18.2 mcg\/dL with an AUC of 0.62 (95% CI, 0.51, 0.74). The sensitivity, specificity, PPV and NPV were 65.4, 62.3, 16 and 94%, respectively. When we combined serum cortisol with persistent vomiting and day of fever, the AUC increased to 0.76. In summary, serum cortisol at day of admission was likely to be associated with dengue severity. Further studies may focus on the possibility of using serum cortisol as one of the biomarkers for dengue severity.<\/jats:p>","DOI":"10.3390\/tropicalmed8030146","type":"journal-article","created":{"date-parts":[[2023,3,6]],"date-time":"2023-03-06T03:02:32Z","timestamp":1678071752000},"page":"146","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Serum Cortisol as a Biomarker of Severe Dengue"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9658-6223","authenticated-orcid":false,"given":"Chansuda","family":"Bongsebandhu-phubhakdi","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Department of Pediatrics, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok 10330, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vichit","family":"Supornsilchai","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Pediatrics, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok 10330, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suphab","family":"Aroonparkmongkol","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Pediatrics, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok 10330, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umaporn","family":"Limothai","sequence":"additional","affiliation":[{"name":"Excellence Center for Critical Care Nephrology, King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand"},{"name":"Center of Excellence in Critical Care Nephrology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand"},{"name":"Tropical Medicine Cluster, Chulalongkorn University, Bangkok 10330, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sasipha","family":"Tachaboon","sequence":"additional","affiliation":[{"name":"Excellence Center for Critical Care Nephrology, King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand"},{"name":"Center of Excellence in Critical Care Nephrology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand"},{"name":"Tropical Medicine Cluster, Chulalongkorn University, Bangkok 10330, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janejira","family":"Dinhuzen","sequence":"additional","affiliation":[{"name":"Excellence Center for Critical Care Nephrology, King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand"},{"name":"Center of Excellence in Critical Care Nephrology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand"},{"name":"Tropical Medicine Cluster, Chulalongkorn University, Bangkok 10330, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Watchadaporn","family":"Chaisuriyong","sequence":"additional","affiliation":[{"name":"Excellence Center for Critical Care Nephrology, King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand"},{"name":"Center of Excellence in Critical Care Nephrology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand"},{"name":"Tropical Medicine Cluster, Chulalongkorn University, Bangkok 10330, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Supachoke","family":"Trongkamolchai","sequence":"additional","affiliation":[{"name":"Banpong Hospital, Ratchaburi 70110, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mananya","family":"Wanpaisitkul","sequence":"additional","affiliation":[{"name":"Banpong Hospital, Ratchaburi 70110, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chatchai","family":"Chulapornsiri","sequence":"additional","affiliation":[{"name":"Banpong Hospital, Ratchaburi 70110, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anongrat","family":"Tiawilai","sequence":"additional","affiliation":[{"name":"Photharam Hospital, Ratchaburi 70120, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thawat","family":"Tiawilai","sequence":"additional","affiliation":[{"name":"Photharam Hospital, Ratchaburi 70120, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terapong","family":"Tantawichien","sequence":"additional","affiliation":[{"name":"Tropical Medicine Cluster, Chulalongkorn University, Bangkok 10330, Thailand"},{"name":"Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok 10330, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Usa","family":"Thisyakorn","sequence":"additional","affiliation":[{"name":"Tropical Medicine Cluster, Chulalongkorn University, Bangkok 10330, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nattachai","family":"Srisawat","sequence":"additional","affiliation":[{"name":"Excellence Center for Critical Care Nephrology, King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand"},{"name":"Center of Excellence in Critical Care Nephrology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand"},{"name":"Tropical Medicine Cluster, Chulalongkorn University, Bangkok 10330, Thailand"},{"name":"Division of Nephrology, Department of Medicine, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok 10330, Thailand"},{"name":"Academy of Science, The Royal Society of Thailand, Bangkok 10300, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,27]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2021, September 25). 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