{
  "abstract": "Background Dengue with warning signs (DWS) represents a critical clinical category requiring hospitalization, yet comprehensive characterization of its clinical features and prognostic determinants remains limited. We aimed to systematically evaluate the clinical spectrum of DWS patients and identify key factors influencing hospitalization outcomes during the 2024 Foshan outbreak.Methods We retrospectively reviewed medical records of 732 hospitalized DWS patients admitted to Foshan Fourth People’s Hospital from July to November 2024. Demographics, comorbidities, symptoms, and laboratory parameters were collected to analyze the incidence and dynamic evolution patterns of clinical manifestations and their association with the length of hospital stay. Ordered logistic regression and multiple linear regression models were employed to explore relevant influencing factors.Results The cohort exhibited a high prevalence of systemic and organ-specific symptoms. Notably, gastrointestinal symptoms were present in 91.8% (672/732) of patients at admission, ranking among the most common manifestations alongside fever and non-specific systemic symptoms. However, distinctive from other symptoms, gastrointestinal manifestations persisted longer: over 40% of patients maintained these symptoms throughout hospitalization, with 49% still affected in the late stage (≥6 days), suggesting delayed intestinal mucosal recovery ( IDDF2026-ABS-0316 Figure 1. Dynamic trend of incidence rate of clinical manifestations during hospitalization). These symptoms predominantly manifested as abdominal pain, diarrhea, and vomiting. Patients with digestive symptoms exhibited significantly elevated alanine aminotransferase (t=-2.229, P=0.026) and triglyceride levels (t=-3.520, P=0.001), indicating concurrent hepatic involvement. Paradoxically, patients presenting with gastrointestinal symptoms on admission had shorter hospitalization (OR=0.463, 95% CI: 0.28-0.766, P=0.003), possibly due to earlier healthcare seeking driven by symptom prominence, prompting timely intervention (IDDF2026-ABS-0316 Figure 2. Clinical manifestations significantly correlated with the length of hospital stay).Conclusions Gastrointestinal manifestations represent a high-burden clinical feature of DWS with distinctive persistence and hepatic correlations. Their presence paradoxically facilitates early medical consultation and reduced hospitalization, underscoring the importance of recognizing these symptoms in dengue-endemic regions to optimize clinical outcomes.Abstract IDDF2026-ABS-0316 Figure 1Abstract IDDF2026-ABS-0316 Figure 2",
  "authors": [
    {
      "affiliations": [
        "BSL-3 Laboratory (Guangdong), Guangdong Provincial Key Laboratory of Tropical Disease Research, Key Laboratory of Infectious Diseases Research in South China, School of Public Health, Southern Medical University, China"
      ],
      "name": "Jianhai Yu"
    },
    {
      "affiliations": [
        "BSL-3 Laboratory (Guangdong), Guangdong Provincial Key Laboratory of Tropical Disease Research, Key Laboratory of Infectious Diseases Research in South China, School of Public Health, Southern Medical University, China"
      ],
      "name": "Yingfang Liu"
    },
    {
      "affiliations": [
        "BSL-3 Laboratory (Guangdong), Guangdong Provincial Key Laboratory of Tropical Disease Research, Key Laboratory of Infectious Diseases Research in South China, School of Public Health, Southern Medical University, China"
      ],
      "name": "Yifan Lin"
    },
    {
      "affiliations": [
        "BSL-3 Laboratory (Guangdong), Guangdong Provincial Key Laboratory of Tropical Disease Research, Key Laboratory of Infectious Diseases Research in South China, School of Public Health, Southern Medical University, China"
      ],
      "name": "Xudong She"
    },
    {
      "affiliations": [
        "Department of Infectious Diseases, The Fourth People’s Hospital of Foshan, China"
      ],
      "name": "Weijin Gong"
    },
    {
      "affiliations": [
        "BSL-3 Laboratory (Guangdong), Guangdong Provincial Key Laboratory of Tropical Disease Research, Key Laboratory of Infectious Diseases Research in South China, School of Public Health, Southern Medical University, China"
      ],
      "name": "Wei Zhao"
    }
  ],
  "title": "IDDF2026-ABS-0316 Clinical characteristics and hospitalization outcomes in dengue patients with warning signs: high burden of gastrointestinal manifestations",
  "uid": "484dee9c-0f1e-5b1f-9bde-2386a30bfd96"
}