Year: 2026 | Month: February | Volume: 16 | Issue: 2 | Pages: 154-161
DOI: https://doi.org/10.52403/ijhsr.20260219
Clinico-Epidemiological Predictors and Modified SOFA Score in Assessing the Severity of Dengue in Hospitalized Children
Shubhradeep Bhowmik1, Sandip Samanta2, Sagardeep Das3, Aravindan Kalaivendan4
1MD Pediatrics, Senior Resident, Infectious Diseases & Beleghata General Hospital, Kolkata (West Bengal), 700010, India
2MD Pediatrics, Associate Professor, Dr. B. C. Roy Post Graduate Institute of Paediatric Sciences, Kolkata (West Bengal), 700054, India
3MD Pediatrics, Post Graduate Trainee, Dept. of Pediatrics, Dr. B. C. Roy Post Graduate Institute of Paediatric Sciences, Kolkata (West Bengal), 700054, India
4MD Pediatrics, Senior Resident, Kauvery Hospital, Chennai (Tamil Nadu), 600018, India
Corresponding Author: Dr. Shubhradeep Bhowmik
ABSTRACT
Introduction: Dengue represents a systemic viral infection characterized by a broad clinical spectrum, encompassing presentations from self-limiting febrile episodes to severe, potentially fatal complications. In the absence of targeted antiviral treatment, prompt recognition of pediatric patients predisposed to severe manifestations of dengue remains essential for effective clinical management.
Aim: This study evaluated the utility of clinico-epidemiological parameters, selected laboratory markers, and the modified Sequential Organ Failure Assessment (mSOFA) score in predicting disease severity and outcomes in hospitalized children with dengue.
Materials and Methods: This prospective observational investigation was carried out across 18 months at a tertiary-level teaching hospital located in Eastern India. Children aged 1 month to 12 years with confirmed dengue infection (NS1 antigen and/or IgM positivity) were included. Patients were classified as Dengue Fever ± Warning Signs or Severe Dengue according to the WHO 2009 criteria. Clinical features, laboratory parameters, and admission mSOFA scores were compared between groups. Correlation between mSOFA score and WHO dengue severity classification was assessed using ROC curves.
Results: Altogether, 196 children were incorporated into the analysis; fever was present in all cases. Common symptoms included vomiting (40.9%) and abdominal pain (21.9%), neither of which predicted disease severity except mucosal bleeding (p < 0.05). Patients experiencing severe dengue demonstrated a statistically significant decline in platelet counts and higher lactate, SGPT, and serum ferritin levels (mean ferritin: 473.36 vs 250.96 ng/mL; p < 0.05). ESR and serum triglycerides were not predictive. The mSOFA score showed a strong positive correlation with dengue severity, with an area under the curve (AUC) of 0.68. All fatalities had mSOFA scores >10.
Conclusion: Thrombocytopenia, elevated SGPT, lactate, and serum ferritin are useful predictors of severe dengue in children, whereas common presenting symptoms have limited prognostic value. The mSOFA score correlates strongly with established dengue severity classification and may serve as a practical prognostic tool in resource-limited settings.
Key words: Dengue, Severity, Children, Predictors, mSOFA, Peadtrics