{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T04:52:35Z","timestamp":1777956755076,"version":"3.51.4"},"reference-count":21,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T00:00:00Z","timestamp":1772755200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T00:00:00Z","timestamp":1772755200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We included 284 patients aged 60\u2009years 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 284 patients, 59.1% of whom were women, with a mean age of 72\u2009years, ranging from 60 to 99\u2009years. 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\u2009ng\/mL; during P2, 143 (50%) serum ferritin levels were collected with an average result of 1697\u2009ng\/mL, and during P3, there were 141 (49.6%) collections with an average level of 949\u2009ng\/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\u2009\u00d7\u20091420\u2009ng\/mL;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006) and convalescent (554\u2009\u00d7\u20091261\u2009ng\/mL;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03) phases, with statistically significant differences.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/tmi.70113","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T12:23:58Z","timestamp":1772972638000},"page":"651-656","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Evaluation of Serum Ferritin Levels and Their Correlation With Clinical Outcomes in Dengue Virus Infection in a Population of Older Adults"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0568-9014","authenticated-orcid":false,"given":"Sacha Orberg","family":"Temer","sequence":"first","affiliation":[{"name":"Infectious Diseases Department Hospital Do Servidor P\u00fablico Estadual de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7282-5453","authenticated-orcid":false,"given":"Tha\u00eds","family":"Guimar\u00e3es","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department Hospital Do Servidor P\u00fablico Estadual de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1269-9958","authenticated-orcid":false,"given":"Augusto","family":"Yamaguti","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department Hospital Do Servidor P\u00fablico Estadual de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jo\u00e3o Silva","family":"de Mendon\u00e7a","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department Hospital Do Servidor P\u00fablico Estadual de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,6]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/nature12060"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473\u20103099(16)00026\u20108"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41564\u2010019\u20100476\u20108"},{"issue":"11","key":"e_1_2_9_5_1","first-page":"2","article-title":"Monitoring of Arboviruses and Closing Balance of the Emergency Operations Committee (COE) Dengue and Other Arboviruses 2024","volume":"55","author":"Ministry of Health (Brazil)","year":"2024","journal-title":"Epidemiological Bulletin"},{"key":"e_1_2_9_6_1","volume-title":"Report on the Epidemiological Situation of Dengue in the Americas: Epidemiological Week 12, 2024","author":"Pan American Health Organization","year":"2024"},{"key":"e_1_2_9_7_1","volume-title":"Dengue: Guidelines for Diagnosis, Treatment, Prevention and Control. New Edition","author":"World Health Organization","year":"2009"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879\u2010018\u20103141\u20106"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms8040589"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0003214"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.20\u20101111"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/rmv.2468"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591\u2010024\u201002798\u2010x"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10092008"},{"issue":"5","key":"e_1_2_9_15_1","first-page":"832","article-title":"Serum Ferritin Levels in Children With Dengue Infection","volume":"39","author":"Chaiyaratana W.","year":"2008","journal-title":"Southeast Asian Journal of Tropical Medicine and Public Health"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00035\u201009"},{"issue":"8","key":"e_1_2_9_17_1","first-page":"1500","article-title":"Advanced Age Is Associated With Increased Risk for Severe Outcomes of Dengue Infection","volume":"29","author":"Huang N.","year":"2023","journal-title":"Emerging Infectious Diseases"},{"issue":"7","key":"e_1_2_9_18_1","first-page":"869","article-title":"Clinical and Laboratory Characteristics and Risk Factors for Fatality in a Population of Older Adults Patients With Dengue Hemorrhagic Fever","volume":"198","author":"Lee I. K.","year":"2008","journal-title":"Journal of Infectious Diseases"},{"issue":"6","key":"e_1_2_9_19_1","first-page":"2089","article-title":"Can Serum Ferritin Levels Predict Severity of Dengue Early?","volume":"7","author":"Petchiappan V.","year":"2019","journal-title":"International Journal of Research in Medical Sciences"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s15010-014-0683-4"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102334\u201011\u2010106"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0010365"}],"container-title":["Tropical Medicine &amp; International Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tmi.70113","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/tmi.70113","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tmi.70113","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T03:58:30Z","timestamp":1777953510000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tmi.70113"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,6]]},"references-count":21,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1111\/tmi.70113"],"URL":"https:\/\/doi.org\/10.1111\/tmi.70113","archive":["Portico"],"relation":{},"ISSN":["1360-2276","1365-3156"],"issn-type":[{"value":"1360-2276","type":"print"},{"value":"1365-3156","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,6]]},"assertion":[{"value":"2025-09-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}