FERRITIN AS A PROGNOSTIC MARKER OF DISEASE SEVERITY IN DENGUE FEVER

This study aimed to evaluate the role of serum ferritin as a prognostic biomarker in assessing disease severity among patients diagnosed with dengue fever. A cross-sectional study was conducted at Lahore Medical & Dental College/Ghurki Trust Teaching Hospital, Pakistan, from April to September 2024. A total of 180 adult dengue-confirmed patients (NS1 antigen or IgM positive) were enrolled. Patients were classified into three severity grades based on WHO 2009 criteria: Grade A (no warning signs), Grade B (with warning signs), and Grade C (severe dengue). Serum ferritin, platelet count, and hematocrit were measured on Day 1 and Day 4 of admission. Kruskal-Wallis H test and ANOVA were used for statistical comparisons. Receiver Operating Characteristic (ROC) analysis was conducted to evaluate ferritin’s predictive performance. Among 180 patients, 52.2% were male and 32.8% were aged 18–25 years. Serum ferritin levels significantly increased with dengue severity on both Day 1 and Day 4 (p < 0.001), while platelet counts decreased (p < 0.001). Hematocrit showed a significant increase only on Day 4 (p = 0.000). ROC analysis revealed that serum ferritin was a strong predictor of severe dengue, with an AUC of 0.863 (95% CI: 0.778–0.947) on Day 1 and excellent predictive value for Grade C dengue (AUC: 0.947; 95% CI: 0.907–0.988). Serum ferritin is a valuable, cost-effective prognostic marker in dengue fever, outperforming traditional markers like platelet count and hematocrit in predicting severity. Early ferritin assessment, especially by Day 4 of illness, can facilitate timely intervention and risk stratification. Larger multicenter studies are needed to validate its routine clinical application.