Tropical medicine & international health : TM & IH · 2026
Evaluation of Serum Ferritin Levels and Their Correlation With Clinical Outcomes in Dengue Virus Infection in a Population of Older Adults.
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Temer Sacha Orberg, Guimarães Thaís, Yamaguti Augusto, de Mendonça João Silva
Аннотация
OBJECTIVES: Prior studies have associated elevated ferritin levels with worse dengue outcomes but data from older adults remain limited. The aim of this study is to evaluate the serum ferritin levels and their correlation with disease severity in a population of older adults.
METHODS: We included 284 patients aged 60 years or older with a diagnosis of dengue attended during a high dengue fever outbreak. We analysed demographic variables, the presence of comorbidities, hospitalisation, death and correlated the serum ferritin level with three categories of dengue. Patients' ferritin levels were recorded during the febrile (P1), critical (P2) and convalescence (P3) phases.
RESULTS: Of the 284 patients, 59.1% of whom were women, with a mean age of 72 years, ranging from 60 to 99 years. Of these, 228 (80.2%) had some clinical comorbidity. 106 (37.3%) of patients were classified as dengue without warning signs; 122 (43%) as dengue with warning signs and 56 (19.7%) as severe dengue. During P1, 68 (23.9%) serum ferritin levels were collected with an average result of 511 ng/mL; during P2, 143 (50%) serum ferritin levels were collected with an average result of 1697 ng/mL, and during P3, there were 141 (49.6%) collections with an average level of 949 ng/mL. 111/284 (39%) of patients requiring hospitalisation and 9/284 (3.1%) died, all of them diagnosed with severe dengue. Our study found higher levels of ferritinemia in cases of severe dengue and in the critical (723 × 1420 ng/mL; p = 0.006) and convalescent (554 × 1261 ng/mL; p = 0.03) phases, with statistically significant differences.
CONCLUSIONS: Our study found higher levels of ferritinemia in cases of severe dengue and in the critical and convalescent phases, with statistically significant differences. Age over 60 may be associated with the development of severe dengue, and hyperferritinemia may represent a biomarker of dengue severity.
METHODS: We included 284 patients aged 60 years or older with a diagnosis of dengue attended during a high dengue fever outbreak. We analysed demographic variables, the presence of comorbidities, hospitalisation, death and correlated the serum ferritin level with three categories of dengue. Patients' ferritin levels were recorded during the febrile (P1), critical (P2) and convalescence (P3) phases.
RESULTS: Of the 284 patients, 59.1% of whom were women, with a mean age of 72 years, ranging from 60 to 99 years. Of these, 228 (80.2%) had some clinical comorbidity. 106 (37.3%) of patients were classified as dengue without warning signs; 122 (43%) as dengue with warning signs and 56 (19.7%) as severe dengue. During P1, 68 (23.9%) serum ferritin levels were collected with an average result of 511 ng/mL; during P2, 143 (50%) serum ferritin levels were collected with an average result of 1697 ng/mL, and during P3, there were 141 (49.6%) collections with an average level of 949 ng/mL. 111/284 (39%) of patients requiring hospitalisation and 9/284 (3.1%) died, all of them diagnosed with severe dengue. Our study found higher levels of ferritinemia in cases of severe dengue and in the critical (723 × 1420 ng/mL; p = 0.006) and convalescent (554 × 1261 ng/mL; p = 0.03) phases, with statistically significant differences.
CONCLUSIONS: Our study found higher levels of ferritinemia in cases of severe dengue and in the critical and convalescent phases, with statistically significant differences. Age over 60 may be associated with the development of severe dengue, and hyperferritinemia may represent a biomarker of dengue severity.