Background: Dengue fever is a significant problem in the public health with the spectrum of mild illness to severe life-threatening disease. This study examined the association between disease severity and serum ferritin levels among dengue patients in different health care facilities. Methods: This cross-sectional study (November 2024 to April 2025) enrolled 180 dengue patients within the first, second, and third level of healthcare services with their classification based on WHO 2009 criteria into Non-Severe Dengue (NSD, n=122, 67.8%) and Severe Dengue (SD, n=58, 32.2%). At admission, demographic, clinical and laboratory data such as hematocrit, platelet count, liver enzymes and serum ferritin were recorded via ELISA. The statistical methods were t-test, Chi-square/Fisher, and p value < 0.05 was used. Results: Patients with severe dengue were older (35.8± 13.1 vs. 31.1± 11.9 years, p=0.032) and had a longer fever (5.3± 1.7 vs. 4.7 ±1.5 days, p=0.041). The pain of the abdomen (n=34, 58.6%) and constant vomiting (n=24, 41.4%) were more common in SD. In SD, hematocrit and liver enzyme were increased and platelets were reduced. Serum ferritin was greatly increased in SD (1834.6 ± 912.5 ng/mL) than in NSD (624.8 ± 355.2 ng/mL, p<0.001) and it was an independent predictor of severe dengue. Conclusion: High serum ferritin is closely related with severe dengue. Together with clinical and routine laboratory values, ferritin measurement at admission may be a useful biomarker of high-risk patient identification and management.
Devi et al. (2026) studied this question.