In conclusion, although some factors were found to have contradictory effects, this meta-analysis identified significant associations between 21 factors (including age, female sex, neurological signs, nausea/vomiting, abdominal pain, gastrointestinal bleeding, hemoconcentration, ascites, pleural effusion, hypoalbuminemia, hypoproteinemia, hepatomegaly, levels of alanine transaminase and aspartate transaminase, thrombocytopenia, prothrombin time, activated partial thromboplastin time, fibrinogen level, primary/secondary infection, and DENV-2) and DSS. Here, F2 is linked to Pleural effusion.