Background: The neutrophil-to-lymphocyte ratio (NLR) is a potential marker for predicting dengue severity, yet its use in pediatric populations remains under-researched. This study aimed to determine the optimal cutoff value of NLR for predicting the severity of dengue infection in children under 14 years in India. Material and Methods: Retrospective data collection was conducted for this observational study over 1 year, from May 2023 to April 2024. Sixty-three children aged 14 years or younger with confirmed dengue fever were included, excluding those with chronic illnesses or immunodeficiencies. NLR on days one and five of hospitalization was noted and associated with the Severity of dengue fever. For analysis, chi-square test, independent t-tests, and the Area under the Receiver operating characteristic (ROC) curves were applied. Results: Enrolled children had a mean (SD) age of 6.1 (3.5) years, with 57.1% being males. On day one, the mean (SD) NLR for mild dengue, moderate dengue, and severe dengue were 1.64 (1.60), 1.81 (1.22), and 1.61 (0.87) respectively (p=0.882). On day five, these values were 1.34 (1.34), 1.29 (0.71), and 1.14 (0.53) respectively (p=0.719) without any significant difference. NLR had an AUC of 0.632 (95% CI: 0.487 to 0.777) for day one and 0.477 (95% CI: 0.389 to 0.661) for day five (p=0.074, not significant). Conclusion: In conclusion, NLR did not significantly differ with dengue severity in the pediatric population during the observed period and was not a statistically significant predictor of dengue severity.
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Verma et al. (2026) studied this question.
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