{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T15:24:49Z","timestamp":1788621889167,"version":"build-2803163510"},"reference-count":71,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,6,22]],"date-time":"2023-06-22T00:00:00Z","timestamp":1687392000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Reviews in Medical Virology"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Serum ferritin levels serves as biomarkers in many inflammatory and infectious diseases. This current systematic review and meta\u2010analysis evaluated whether serum ferritin levels are associated with severe dengue and its utility as a biomarker of disease severity. Literature searches were conducted in PubMed, Scopus, ScienceDirect, the Cochrane library, and Google Scholar. A total of 18 studies examining the serum ferritin levels in dengue cases in the context of disease severity (nine studies having dengue classification as non\u2010severe vs. severe dengue cases, and nine studies having dengue classification as dengue without warning signs (DwoWS), dengue with warning signs (DwWS), and severe dengue cases) were included and the quality of the studies was assessed using the Quality in Prognostic Factor Studies tool. The meta\u2010analysis was performed using STATA software to calculate the effect size as a standardized mean difference (SMD) or Hedges \u2018g\u2019 for the continuous outcome. Higher serum ferritin levels were found in severe dengue cases compared to non\u2010severe cases [SMD (Hedges \u2018g\u2019) 4.05 (95% C.I. 2.09\u20136.00), (<jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a098.8%)]. In the second group, DwWS cases showed high serum ferritin levels compared to DwoWS [SMD 2.01 (95% C.I. 0.92\u20133.10), (<jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a097.89%)], and severe dengue cases showed higher levels of serum ferritin compared to DwWS [SMD 2.66 (95% C.I. 1.72\u20134.48), (<jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a098.78%)] and DwoWS cases [SMD 6.65 (95% C.I. 1.72\u201311.59), (<jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a099.78%]. Subgroup analysis for the country of study (India vs. others), ferritin testing methods, and ferritin measurement day revealed testing method as a significant contributor to heterogeneity. To conclude, the present study suggests serum ferritin as a prognostic marker for dengue disease severity. Multi\u2010centric studies involving a large number of dengue patients with a uniform case definition accounting for all the confounding variables might help in determining a universal cut\u2010off value to discriminate between non\u2010severe and severe dengue.<\/jats:p>","DOI":"10.1002\/rmv.2468","type":"journal-article","created":{"date-parts":[[2023,6,24]],"date-time":"2023-06-24T21:06:00Z","timestamp":1687640760000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Serum ferritin level as a prognostic biomarker for predicting dengue disease severity: A systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"33","author":[{"given":"Shridhar","family":"Shukla","sequence":"first","affiliation":[{"name":"Diagnostic Reagent Facility ICMR\u2010National Institute of Virology  Pune Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santosh 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