Dengue Viral Infection (DVI) has emerged as one of tropical belts’ most common mosquito-borne diseases worldwide. This study was an attempt to evaluate the patterns of renal involvement in DVI and its effect on morbidity and mortality arising from the illness. This study was conducted on 170 patients hospitalized with the diagnosis of Dengue fever in the Emergency department of the Post Graduate Institute of Medical Education and Research, Chandigarh, from July 2022 to September 2023. All clinical and laboratory parameters of the patient were recorded. To evaluate patterns of renal involvement, patients underwent urine dipstick, urine routine and microscopy, spot urine protein/creatinine ratio, creatinine and ultrasonography. Patients with renal involvement were followed up for four weeks and 12 weeks. The median age was 36 years, with 60% male patients. A total of 51 patients (30%) had renal involvement, and 36 (21.17%) had Acute Kidney injury. Ten patients developed KDIGO Stage 3 AKI, of which 7 required renal replacement therapy. Forty-seven (27.6%) patients developed urinary abnormalities (which included proteinuria, hematuria, and active sediments in urine). Patients with renal involvement had significantly higher mortality (p-value <0.001). Among the patients who survived, renal abnormalities resolved in all except one, who progressed to chronic kidney disease. Renal biopsy was done in three patients, and cast nephropathy was seen in all. This study establishes that renal involvement accompanies higher mortality in patients with DVI, thereby underscoring the importance of its evaluation for the management and prognostication of patients.

Objectives: To describe clinico-virological profile, treatment details, intensive care needs, and outcome of infants with acute viral bronchiolitis (AVB). Methodology: In this prospective study, 173 infants with AVB admitted to Pediatric emergency and Pediatric intensive care unit (PICU) of a tertiary care teaching hospital in North India during November 2019 to February 2020 were enrolled. The data collection included clinical features, viruses detected, complications, intensive care needs, treatment, and outcome. Multivariate analysis was performed to determine independent predictors for PICU admission. Results: Patients had rapid breathing (98.8%), cough (98.3%), and fever (74%). On examination, tachypnea (98.8%), chest retractions (93.6%), respiratory failure (84.4%), wheezing (49.7%), and crepitations (23.1%) were observed. RSV and rhinovirus were predominant isolates. Complications were noted in 25% cases as encephalopathy (17.3%), transaminitis (14.3%), shock (13.9%), AKI (7.5%), myocarditis (6.4%), MODS (5.8%), and ARDS (4.6%). More than one-third cases required PICU admission requiring nasal cannula oxygen (11%), continuous positive airway pressure (51.4%), high flow nasal canula (14.5%), and mechanical ventilation (23.1%); nebulization (74%); antibiotics (35.9%); and vasoactive drugs (13.9%). The mortality was 8.1%. Underlying comorbidity; chest retractions, respiratory failure, and low oxygen saturation at admission; presence of shock; and need of mechanical ventilation were independent predictors of PICU admission. Isolation of virus or co-infection were not associated with disease severity, intensive care needs, and outcome. Conclusion: Among infants with AVB, RSV and rhinovirus were predominant; >1/3rd required PICU admission; and comorbidity; chest retractions, respiratory failure, low oxygen saturation; shock; and need of mechanical ventilation independently predicted PICU admission.