Comparison between blood hemoglobin concentration determined by point-of-care device and complete blood count in adult patients with dengue

Author summary The natural history of dengue has the unique characteristic of plasma leakage that results in hemoconcentration as well as vasculopathy and thrombocytopenia that result in bleeding. Therefore, hematocrit monitoring is a crucial tool to guide management in dengue patients. Microhematocrit adjunct with a complete blood count (CBC) to monitor dengue patients were traditionally performed to decrease the frequency of venipuncture. However, microhematocrit is currently less preferred to the point-of-care hemoglobin monitoring tools to measure red cells in other diseases. There has been no study investigating the feasibility of using point-of-care hemoglobin (POC-Hb) to monitor dengue patients. We studied the correlation of hemoglobin measured by POC-Hb testing and hematocrit measured by an automated CBC in adult dengue patients. We were able to show a strong positive correlation between the two measurements (r = 0.869, p = 20% above the convalescent value as the criteria for detecting hemoconcentration by POC-Hb testing, measurement of hemoglobin using POC-Hb has a sensitivity of 71.4% for detecting hemoconcentration compared to the traditional hematocrit criteria. Our findings support the use of POC-Hb testing adjunct with a complete blood count to guide fluid management in dengue patients. Background Hematocrit measurement has been an indispensable tool for monitoring plasma leakage and bleeding in dengue patients. However, hematocrit measurement by automated methods is hampered by frequent venipunctures. Utility of point-of-care hemoglobin (POC-Hb) test for monitoring dengue patients has not been established. We evaluated the relationship between hemoglobin measured by POC-Hb testing and hematocrit measured by the automated method in adult dengue patients. Methodology and principal findings Adult dengue patients were recruited at two university hospitals in Thailand from October 2019 to December 2020. POC-Hb test was performed using capillary blood simultaneously with venipuncture to obtain whole blood for an automated complete blood count (CBC) analysis. The correlation of hemoglobin and hematocrit measurement was evaluated. A total of 44 dengue patients were enrolled. Twenty-nine patients (65.9%) were female, with a median age of 31 years (interquartile range 22-41). Of the enrolled patients, 30 (68.2%), 11 (25.0%), and 3 (6.8%) were classified as dengue without warning signs, with warning signs, an