Consequências neurológicas da dengue: uma revisão sistemática

Abstract

Dengue is an infectious disease that is associated with neurological consequences due to its ability to invade the Central and Peripheral Nervous Systems. The objective of this study is to systematically review the literature and identify the most frequent neurological complications associated with individuals infected with dengue.Observational studies were included without restrictions on period, sex, or age group, and published in English, Portuguese, or Spanish. Cases in which dengue diagnosis could not be laboratory-confirmed and studies with cross-sectional, series, or case report designs, as well as cases of co-infection and post-mortem studies, were excluded. The search strategy was conducted in the MEDLINE/PubMed, Scopus, and Web of Science databases and included studies published up to March 2025. Methodological quality was assessed using the Newcastle-Ottawa Scale. After applying the eligibility criteria, 65 articles were included, comprising a sample of 804,098 patients with laboratory-confirmed dengue, of whom 9,059 presented neurological consequences (1.13%), most commonly encephalitis, encephalopathy, Guillain-Barré syndrome, myelitis, myositis, seizures, and hypokalemic paralysis. The DENV-2 and DENV-3 serotypes were identified in the majority of the investigated cases. Mechanisms such as direct viral invasion, autoimmune reactions, metabolic disturbances, and hemorrhagic processes may be involved in the neuropathogenesis of dengue. This systematic review is the first to comprehensively summarize the evidence on the neurological consequences of dengue, revealing a considerable number of cases and a wide variety of manifestations. The findings highlight the importance of early recognition of these complications and the need for further studies on the neuropathogenesis of the disease.