GPT and asthenia: Thus, these studies have reported widely varying results of the clinical factors associated with severe dengue, including having secondary dengue infections, age >37 years, male gender, presence of intense asthenia, presence of abdominal pain, presence of cough, presence of bleeding, a mean arterial pressure (MAP) less than 80 mmHg, an increase in hematocrit levels to more than 2 % over the reference range (adjusted for gender), low lymphocyte level, higher aspartate aminotransferase (AST) or alanine aminotransferase (ALT) levels by more than 3 times, and low total protein level [10–14].