Dengue virus is known to modulate host cell lipid metabolism in order to promote efficient viral replication. Recent studies have focused on circulating
lipids as potential
biomarkers of
dengue severity; however, the results obtained so far lack the consistency to establish a definite relationship between the two. Therefore, in the present study, we investigated serum
lipids as potential
biomarkers of
dengue severity by conducting a meta-analysis of the currently available clinical data. Nine studies that evaluated 1,953 patients were included in the review, many of which were cross-sectional (44.4%) and conducted in Asian countries (55.5%). These studies observed the presence of
lipids in serum samples (77%) of patients in the acute phase of the disease (88.8%). Circulating total-
cholesterol (P = .001) and
LDL (P = .001) levels, but not HDL (P = .07), VLDL (P = .9) and
triglyceride (P = .57) levels, were inversely and significantly correlated with
dengue severity. Total
cholesterol (P ≤ .001) and
LDL (P = .001) were also useful in determining the risk of
hypovolemic shock in patients with
severe dengue. Subgroup analysis showed that factors, such as design (cross-sectional vs cohort), racial-ethnic differences (Asian vs Latin Americans), and age range (children vs adult) influenced the correlation and also contributed to the high level of heterogeneity in the studies. Our meta-analysis demonstrates that total-
cholesterol and
LDL-cholesterol levels should be explored as routine
laboratory markers for
dengue severity, as they will help in employing an appropriate patient
therapy, and thus optimize the use of available resources.