Jurnal Kedokteran Brawijaya
Vol. 34 No. 2 (2026)

Combined Interleukin-6 and C-Reactive Protein Predict Severe Dengue: Development of a Prediction Model

Sholihah, Nikmatus (Unknown)
Iskandar, Agustin (Unknown)
Ratridewi, Irene (Unknown)
Indiastari, Dewi (Unknown)
Putri, Hayati Rizki (Unknown)
Putra, Septian Dwi (Unknown)
Reinaldo, Kevin (Unknown)
Raissa, Mira (Unknown)
Wijayanto, Aditya (Unknown)
Yeftana, Sena (Unknown)



Article Info

Publish Date
20 Aug 2026

Abstract

Background: Dengue is still a major health problem in Indonesia and often leads to hospitalization. In severe cases, it can cause fluid leakage, bleeding, and organ damage. IL-6 and CRP are known to rise in more serious infections, but their combined usefulness is not yet clear. Objective: This study evaluates whether combined IL-6 and CRP levels can predict early severe dengue. Methods: This is an observational study of 82 patients with confirmed dengue infection treated in Dr. Saiful Anwar General Hospital, Malang, Indonesia, from July to September 2024. The severity status was classified according to the WHO 2009 severity classification. IL-6 was measured by enzyme-linked immunosorbent assay, and CRP was measured by immunoturbidimetry. Model performance was evaluated by logistic regression and receiver operating characteristic (ROC) analysis. Internal validation used 1,000 bootstrap resamples. Results: Both biomarkers showed significantly higher median values in severe cases than in non-severe cases (163.88 vs. 58.88 pg/mL and 8.07 vs. 2.43 mg/L, respectively; both p < 0.001). IL-6 (ρ = 0.562) and CRP (ρ = 0.481) showed moderate positive correlations with disease severity. Both biomarkers independently predicted severe dengue, with IL-6 (adjusted OR = 1.010, p = 0.004) and CRP (adjusted OR = 1.192, p = 0.009). The Brier score was 0.161, and the optimism-corrected AUC was 0.834. DeLong testing showed no significant difference between the combined model and IL-6 alone (p = 0.602) or CRP alone (p = 0.061). Conclusions: The combined IL-6 and CRP model shows potential for early prediction of severe dengue.

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Journal Info

Abbrev

jkb

Publisher

Subject

Medicine & Pharmacology

Description

JKB contains articles from research that focus on basic medicine, clinical medicine, epidemiology, and preventive medicine (social medicine). ...