Mechanistic constraints in dengue severity: a systematic review with evidence stratification and agent-based evaluation of logical sufficiency - Takeaways - MDSpire

Mechanistic constraints in dengue severity: a systematic review with evidence stratification and agent-based evaluation of logical sufficiency

  • By

  • Roberto Navarro Quiroz

  • Katherine Escorcia Lindo

  • Andrea Jaruffe Pinilla

  • Yiris Diaz-Olmos

  • Noelia Geribaldi-Dóldan

  • Cecilia Fernández-Ponce

  • Eloina Zarate Peñata

  • Yesit Bello Lemus

  • Lisandro Pacheco Lugo

  • Leonardo Pacheco Londoño

  • Antonio Acosta-Hoyos

  • Nataly Galan Freyle

  • Elkin Navarro Quiroz

  • June 19, 2026

  • 0 min

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  • 1

    Severe dengue is characterized by plasma leakage, thrombocytopenia, hemorrhage, and can lead to dengue shock syndrome.

  • 2

    The review identified three mechanism families with C1 conditional evidence: NS1-linked vascular permeability, endothelial glycocalyx disruption, and myeloid effector activation.

  • 3

    Two null randomized trials showed that rupatadine and oseltamivir did not significantly improve outcomes in severe dengue cases.

  • 4

    An agent-based model demonstrated that the NS1-barrier-myeloid set can generate a connected endothelial-barrier failure analog under specific conditions.

  • 5

    The study emphasizes the need for longitudinal cohorts and functional assays to validate mechanistic claims in severe dengue.

Original Source(s)

Mechanistic constraints in dengue severity: a systematic review with evidence stratification and agent-based evaluation of logical sufficiency

  • by Roberto Navarro Quiroz, Katherine Escorcia Lindo, Andrea Jaruffe Pinilla, Yiris Diaz-Olmos, Noelia Geribaldi-Dóldan, Cecilia Fernández-Ponce, Eloina Zarate Peñata, Yesit Bello Lemus, Lisandro Pacheco Lugo, Leonardo Pacheco Londoño, Antonio Acosta-Hoyos, Nataly Galan Freyle, Elkin Navarro Quiroz

  • June 19, 2026

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