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Background: Dengue infection is a major public health threat; early recognition is crucial to improve the survival in severe dengue. For prediction of dengue, various biomarkers are present but they are rarely used. We used serum ferritin to predict the severity at an earlier stage.Methods: This is a prospective observational study conducted in a tertiary health care centre involving 200 dengue cases diagnosed by positive NS1 antigen by ELISA. Serum ferritin was measured in all at the time of diagnosis, day 3 and day 7. We monitored the patients both clinically and biochemically daily and classified them as severe and non-severe according to 2009 WHO criteria.Results: The mean age of the patients was 34.14±12.4 years. Out of 200 patients, 136 (68.0%) patients were male and rest 64 (32.0%) were females, 56 developed severe dengue. All the 200 patients had fever (100%) and arthralgia (100%). Other clinical symptoms like rash, nausea, abdominal pain, persistent vomiting, mucosal bleeding, liver enlargement, clinical fluid accumulation, dengue haemorrhagic fever, dengue shock syndrome, altered sensorium, severe plasma leakage, and patients with ALT more than 1000 U/L was reported in 108 (54.0%), 58 (29.0%), 46 (23.0%), 59 (29.5%), 32 (16.0%), 19 (9.5%), 13 (6.5%), 9 (4.5%), 35 (17.5%), 2 (1%), 12 (6.0%) and 3 (1.5%) patients respectively. The serum ferritin level was correlated with patients having rash, abdominal pain and persisting vomiting both on day 3 and day 7. A negative correlation was observed between serum ferritin level and total platelets count both on day 3 (r=-0.2226; p=0.0016) and day 7 (r=-0.3562; p=0.0001). Patients with severe dengue had significantly low platelet count and higher ferritin levels.Conclusions: Elevated serum ferritin levels can be used as a potential early prognostic marker to predict the severity of dengue infection in clinical practice.

Prognostic significance of hyperferritinemia in dengue: A tertiary health care centre study