Abstract
Objective: To verify whether thrombocytopenia is a predictor of severity in dengue in patients older than 15 years. Methods: This is a systematic review of the literature, which was carried out in February 2021 by using the VHL Health portal. Results: The initial search resulted in 260 articles, and after applying the inclusion and exclusion criteria, 17 articles were analyzed whose population was composed of adults over 15 years of both sexes with a confirmed diagnosis of dengue. The number of evaluated patients between the studies ranged from 32 to 22,777 (median: 320). The platelet count varied between the acute and critical phases of the disease, remaining around 100,000 / mm³ in the acute phase, but reaching values of 51,000 / mm³ in the critical one. Five studies evaluated different discriminatory platelet values that were significantly associated with unfavorable outcomes such as death and prolonged hospitalization. Although these values are variable, they were mostly less than or equal to 50,000 / mm³. Final considerations: Thrombocytopenia was an early alteration and associated with unfavorable outcomes, which reinforces the need to maintain the platelet count in the stratification of dengue severity, and may even act as its independent discriminator.