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DENGUE infection raised two-year hospitalization risk and added measurable disability burden in Singapore’s linked national cohort.
Dengue Infection and Two-Year Sequelae Risk
A large retrospective cohort study used Singapore’s linked national dengue surveillance and health care claims data to estimate postacute outcomes over the two years following dengue infection. Adults with dengue first notified between January 1, 2013, and June 30, 2022 were included, with exclusions for early death, reinfection, and certain SARS-CoV-2 timing windows. Each case was compared with matched controls with no recorded dengue, and analyses used overlap weighting to balance baseline characteristics.
Across 68,145 dengue infected adults and 2,886,119 controls, dengue infection was associated with higher risk of all cause hospitalization over two years. The study also found a modest but significant increase in risk for any prespecified multisystem sequelae captured in claims data, spanning cardiovascular, neuropsychiatric, autoimmune, kidney, endocrine, and gastrointestinal conditions.
Disability Adjusted Life Years (DALYs) Quantify the Burden
Beyond risk estimates, the investigators translated excess sequelae into a disability burden using disability-adjusted life-years (DALYs). They estimated 1,670 excess DALYs attributable to postacute sequelae during follow up, equivalent to 2.52 DALYs per 100 dengue infections. Neuropsychiatric sequelae accounted for the largest share of this burden, with smaller contributions from endocrine, kidney, and gastrointestinal sequelae.
Importantly, while risks for several organ system outcomes declined during the second year, elevated risks persisted for all cause hospitalization and for neuropsychiatric, kidney, and gastrointestinal complications. Excess DALYs were higher in older adults, people with comorbidities, and those living in public housing, suggesting the long tail of acute dengue infection may be concentrated in more vulnerable groups.
Even as risks across several systems declined in year two, elevated risks persisted for hospitalization and select complications. The burden was concentrated in older adults and those with comorbidities, highlighting uneven longer term impact after dengue infection.
Reference: Chow JY et al. Complications, deaths, and disability burden in the 2 years following dengue infection. JAMA Netw Open. 2026;9(2):e2559108.