Serum Calcium Levels as a Marker of Dengue Severity: A Clinical Observational Study

Dengue fever continues to pose a major global health challenge. Electrolyte disturbances, particularly hypocalcemia, are frequently observed in dengue but are underutilized for prognostication.

To evaluate the relationship between corrected serum calcium levels and dengue severity.

A prospective observational study of 210 adult patients with confirmed dengue was conducted at Shiv Ram Hospital. Serum calcium was measured within 24 hours of admission and corrected for albumin. Severity was classified per World Health Organization (WHO) 2009 criteria. Correlation analyses and multivariate logistic regression were used to assess associations with clinical and laboratory parameters.

Mean corrected serum calcium declined with increasing severity (group A: 8.39 ± 0.59 mg/dL, group B: 8.05 ± 0.62 mg/dL, group C: 7.61 ± 0.67 mg/dL; p < 0.001). Hypocalcemia (<8.5 mg/dL) was observed in 91.3% of severe cases. Calcium levels negatively correlated with hematocrit, platelet count, and hospitalization duration (p < 0.01). Hypocalcemia independently predicted severe dengue (aOR: 3.94; 95% CI: 1.98-7.84; p < 0.001).

Hypocalcemia is a frequent and significant predictor of severe dengue. Serum calcium offers a simple, cost-effective tool for early triage and management in dengue-endemic regions.