Association of clinical parameters and serum ferritin with dengue fever severity and in-hospital outcome in children aged 1 month to 12 years: a prospective, observational study at a tertiary care center in central India

Abstract

OBJECTIVE: This work aimed at studying clinical parameters observed at admission and defervescence and serum ferritin levels measured at two states and their association with dengue severity and survival. PATIENTS AND METHODS: In a prospective, observational study conducted at a tertiary care center in central India, children aged 1 month-12 years of age, who were admitted in the hospital with a diagnosis of dengue fever (NS1 antigen or IgM/IgG status positive) and presenting within 84 hours of fever onset, were included. Clinical parameters and serum ferritin levels at admission and defervescences were recorded and measured. RESULTS: Between October 2018 and October 2020, 92 dengue-positive children were enrolled. The mean age was 6.58±3.50 years, and 56.5% were female. NS1 antigen positivity was seen in 89.1% of cases. Severe disease was seen in 12% of cases, whereas in-hospital mortality rate was 3.2%. Systolic and diastolic blood pressure, pulse pressure <20 mmHg, hepatomegaly, reduced urine output and bleeding manifestations identified on admission as well as in defervescence were associated with severity and mortality in children with dengue fever. Serum ferritin levels on admission and defervescence were also associated with dengue severity (p = 0.0001 and p = 0.0012, respectively) and in-hospital mortality (p = 0.0013 and p = 0.0151, respectively). CONCLUSIONS: Clinical parameters and serum ferritin levels on admission and in defervescence are associated with severe dengue and can predict in-hospital mortality.

Keywords

• dengue fever
• children
• serum ferritin
• mortality