Serum Ferritin Level in Children with Severe Dengue Infection and Its Association with Outcome: A Single-center Prospective Cohort Study.

Abstract

Background and aims: Dengue viral infection (DENVI) can vary from a simple fever to severe dengue infection (SDI) and death. The study aims to identify the utility of serum ferritin (SF) and its association with intensive care unit (ICU) mortality in children with SDI.

Patients and methods: This is a prospective cohort study of 144 children aged 1 month to 18 years admitted to the pediatric intensive care unit (PICU) with SDI. The association between peak SF level with disease severity and outcome variables were assessed. A receiver-operating characteristic curve and a logistic regression analysis were conducted to evaluate the association of peak SF levels with ICU mortality.

Results: Our study included 144 children; 83 (57.6%) were males and 61 (42.36%) were females. Among these, 131 (90.97%) recovered, 9 (6.25%) died, 3 (2.08%) underwent liver transplant, and 1 (0.69%) left against medical advice. Median peak SF level was 6732 ng/mL (range 2813-17890 ng/mL). Majority of our patients recovered with standard supportive management alone. In our study, a peak SF level of 15691 ng/mL observed during the PICU stay was a "good" predictor of mortality among patients with SDI, with an area under curve of 0.826. Peak SF level greater than 10000 ng/mL (n = 51/144) was significantly associated with the development of disease-related complications (p < 0.05).

Conclusion: Hyperferritinemia is common among children with SDI. A peak SF level > 10000 ng/mL is associated with a higher risk of mortality and disease related complications.

How to cite this article: Jha NP, Gupta T, Krupanandan R, Sadasivam K, Kapalavai SK, Ramachandran B. Serum Ferritin Level in Children with Severe Dengue Infection and Its Association with Outcome: A Single-center Prospective Cohort Study. Indian J Crit Care Med 2025;29(5):458-462.