JPSIM Journal of Pakistan Society of Internal Medicine J Pak Soc Intern Med 2709-8729 2710-0804 Pakistan Society of Internal Medicine 10.70302/jpsim.v7i2.2624 jpsim.v7i2.2624 Original Research Clinical Utility of NS1 Antigen level in Predicting Severity of Thrombocytopenia, Transaminitis and Appearance of Warning Signs in Dengue Patients Khan Kinza Chachar Aijaz Zeeshan Khan Shahid Fatima Iqbal Javeid Khan Danish Khan Khurshid dockhan@live.com * The University of Pennsylvania/HUP, Philadelphia, PA, USA Fatima Memorial Hospital/ College of Medicine and Dentistry, Lahore, Pakistan Medical Unit-II, Services Hospital, Lahore, Pakistan Medicine, Central Park Medical College, Lahore, Pakistan *Correspondence: Khurshid Khan (dockhan@live.com) 03 06 2026 2026 7 2 122 126 01 09 2025 13 04 2026 04 05 2026 Copyright © 2026 The Author(s) 2026 The Author(s) https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objectives

To find an association between plasma levels of NS1 antigen with thrombocytopenia, Transaminitis and appearance of warning signs that can help to better manage high-risk cases that would develop into DHF/DSS

 Methodology

This retrospective study analyzed 136 dengue patients admitted to the Department of Medicine at Fatima Memorial Hospital for dengue fever from August 1, 2022, and November 30, 2022. Qualitative and quantitative data was collected including warning signs of abdominal pain, persistent vomiting, mucosal bleeding, rising hematocrit from baseline, narrow pulse pressures, NS1 antigen levels, platelet levels, and ALT/AST levels. Pearson Correlation Coefficient was calculated to show correlation between quantitative laboratory variables with NS1 antigen.

 Results

The median NS1 antigen was 13 (IQR 17.7), the median platelet count was 52 (IQR 67), A total of 134 (98.5%) patients were sent home safely after management which showed median NS1 antigen levels of 13(17.27) whereas 2 patients (1.5%) who died showed median Ns1 antigen level was 22.1.There was statistically significant inverse correlation (p

 Conclusion

On the whole; NS1 antigen's potential for risk assessment and early intervention in severe dengue cases, suggesting a shift from reactive to proactive care in dengue management. Although limited by sample size and single-center design, this study underscores the clinical value of NS1 antigen in improving patients’ outcomes and warrants further validation in larger, multi-center studies.

 Keywords NS1 Antigen Dengue Fever Dengue Hemorrhagic Fever Thrombocytopenia Transaminitis Clinical Utility Dengue Hemorrhagic Fever. Ethics Statement

Ethics committee: Institutional Review Board, Fatima Memorial Hospital College of Medicine and Dentistry, Lahore, Pakistan. Approval number: FMH/11/01/2023-IRB-1167, dated January 23, 2023.

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