Role of Serum Ferritin as a Predictor of Dengue Severity: A Prospective Observational Study From India

Abstract

Background: Early detection of dengue fever progression to severe form using simple measurable tests is crucial for initiating appropriate supportive therapy. This study aimed to assess whether serum ferritin is an indicator of severity in dengue patients. Material and methods: This hospital-based prospective observational study was done on 70 patients admitted in wards and intensive care unit (ICU) of Aditya Birla Memorial Hospital, Pune, India, and Jaipur Golden Hospital, Delhi, India, satisfying inclusion criteria during the study period. Dengue cases were classified as those who had non-structural protein 1 (NS1) positivity on days 2-8 and/or positive immunoglobulin M (IgM) on days 6-10, while those with other confirmed diagnoses were considered as other febrile illnesses. The outcome of this study was to see an association between serum ferritin levels and severity of illness, condition at the time of discharge/death, and the length of hospitalization. Results: Mean serum ferritin (ng/mL), platelet count (cells/mm 3 ), and hospital stay (in days) were 1469.43±297.53, 17289.29±8254.47, and 6.01±3.90, respectively. Subjects with severe dengue had significantly higher mean serum ferritin levels and median hospital stays compared to those with non-severe dengue (p<0.05). A moderate (Pearson correlation coefficient ρ=-0.35, p=0.0027) negative correlation was found between serum ferritin level and platelet count whereas a moderate (ρ=0.50, p=0.0000) positive correlation was found between serum ferritin level and hospital stay. Conclusion: Serum ferritin levels can be used as a tool to help differentiate between severe and non-severe dengue.