Serum Ferritin as a Biomarker of Disease Severity in Dengue Fever

Abstract

Background: Dengue fever, a globally prevalent mosquito-borne viral disease, poses significant public health challenges due to its potential for severe complications such as dengue hemorrhagic fever and dengue shock syndrome. Identifying early biomarkers to predict disease severity is crucial for timely intervention. Recent studies have pointed toward ferritin—a key iron-storage protein—as a possible indicator of disease progression. Objective: This study investigates the role of serum ferritin levels as a biomarker for severity assessment in patients hospitalized with dengue fever. Methods: A retrospective cross-sectional study was conducted on 18 laboratory-confirmed dengue patients aged 8–80 years admitted to a tertiary care hospital between August 2022 and January 2023. All the patients were hospitalized and their ferritin levels were ≥ 300 ng/mL. Ferritin levels and other clinical parameters were compared between patients with uncomplicated and complicated dengue. Comparative analysis was also done with cases of urinary tract infections (UTI), chronic kidney disease (CKD), enteric fever, and other viral illnesses. Results: Mean serum ferritin levels were significantly elevated in complicated dengue cases (10,292.5 ng/mL) compared to uncomplicated cases (1,448.1 ng/mL). Higher ferritin levels were also observed in females and patients under 50 years of age, though statistical significance varied. Dengue patients showed significantly higher ferritin levels than those with UTI and CKD. No correlation was found between ferritin and hemoglobin levels. Conclusion: Elevated ferritin levels are strongly associated with disease severity in dengue fever and may serve as a reliable biomarker for early identification of high-risk patients. This has important implications for clinical management and prognosis.