Zinc deficiency as severity predictor in pediatric dengue viral infection: a meta-analysis

Background: Endothelial cells in dengue viral infection (DVI) produce Tumor Necrosis Factor (TNF-α) in abundant number from zinc deficient patients rather than non deficient. This finding suggest zinc is protective for maintenance of endothelial cell, thus decrease the severity of dengue viral infection. Aim: In this meta-analysis, we will compare the zinc serum in deficient and non deficientpatients from several studies as predictor in dengue viral infection. Methods: We included all research articles in pediatric patients diagnosed with Dengue Fever or Dengue Hemorrhagic Fever with information on zinc serum available. Zinc deficiency is reported to be below 9,18 µmol/LThe severity is divided into dengue fever against dengue hemorrhagic fever. Result: There were 217 patients included in this study. The meta-analysis showed that there are significant difference in both results (OR 6.32 [3.50 - 11.40], p = 0.0003; I²: 84%, p < 0.00001). Conclusion: Zinc deficiency in pediatric dengue viral infection can be used for the predictor of severityin dengue viral infection.