Correlation of Serum Calcium Levels with Severity of Dengue in Children:  A Cross-Sectional Observational Study.

K Praveen  Kumar; Ravula Chaitanya  Jyothi; Dr. Ramya Madhuri  Yendamuri; V. Murali  Krishna

doi:10.51168/sjhrafrica.v6i9.2152

Authors

Dr. K Praveen Kumar Senior Resident, Department of Pediatrics, Government Medical College and Hospital,Vikarabad, Telangana, India
Dr. Ravula Chaitanya Jyothi Associate Professor, Department of Pediatrics, Government Medical College and Hospital, Gadwal, Telangana, India
Dr. Ramya Madhuri Yendamuri Associate Professor, Department of Pediatrics, Government Medical College and Hospital, Siddipet, Telangana, India
Dr. V. Murali Krishna Professor, Department of Pediatrics, Niloufer Hospital, Osmania Medical College, Hyderabad, Telangana, India

DOI:

https://doi.org/10.51168/sjhrafrica.v6i9.2152

Keywords:

Dengue fever, Hypocalcemia, Ionized calcium, Pediatric patients, Disease severity, Biomarker

Abstract

Background:
Dengue fever is a significant pediatric health burden in tropical countries. Predicting severe cases early remains crucial to reducing morbidity and mortality. Hypocalcemia has been implicated in dengue pathogenesis, but its clinical utility as a prognostic marker in children requires further evaluation.

Objectives:

To estimate serum calcium levels in children with dengue and analyze their correlation with disease severity.

Methods:

This cross-sectional observational study was conducted over 24 months at Niloufer Hospital, Hyderabad, involving 100 children aged 1 month to 12 years with serologically confirmed dengue. Demographic data, clinical features, and laboratory findings were recorded. Serum total and ionized calcium levels were measured within 24 hours of admission. Statistical analysis was performed using SPSS v17.0. ANOVA, chi-square test, and Spearman’s correlation were applied; p<0.05 was considered significant.

Results:

The mean age of participants was 5.8 ± 3.6 years, with a male predominance (58%). Fever was universal, followed by myalgia (76%), vomiting (44%), and abdominal pain (33%). Severe dengue was identified in 7% of cases. Mean serum calcium and ionized calcium levels were significantly lower in severe dengue (7.2 ± 0.5 mg/dL and 0.96 ± 0.10 mmol/L, respectively) compared with dengue without warning signs (8.5 ± 0.4 mg/dL and 1.18 ± 0.06 mmol/L, p = 0.01). Strong negative correlations were observed between calcium levels and disease severity (Spearman’s rho –0.651 for total calcium; –0.724 for ionized calcium). Mortality was 3%.

Conclusion:

Hypocalcemia, particularly low ionized calcium, correlates strongly with the severity of pediatric dengue and can be a sensitive early biomarker for risk stratification.

Recommendations:

Routine estimation of ionized calcium should be incorporated into the clinical evaluation of dengue in children. Early correction of hypocalcemia may prevent complications. Larger multicenter studies are warranted to validate calcium monitoring as a prognostic and therapeutic tool.

Author Biographies

Dr. K Praveen Kumar , Senior Resident, Department of Pediatrics, Government Medical College and Hospital,Vikarabad, Telangana, India

is currently serving as a Senior Resident in the Department of Pediatrics at Government Medical College, Vikarabad, Telangana. He obtained his MBBS (Bachelor of Medicine and Bachelor of Surgery) degree from Xiamen University, China (2018), followed by internship training at Christian Medical College and Hospital, Vellore. He pursued an MD in Pediatrics at Niloufer Hospital, Osmania Medical College (2022–2025). His academic interests include pediatric critical care and infectious diseases, and he is actively involved in clinical care, research, and teaching. ORCID iD: https://orcid.org/0009-0009-1505-8786

Dr. Ravula Chaitanya Jyothi , Associate Professor, Department of Pediatrics, Government Medical College and Hospital, Gadwal, Telangana, India

is an Associate Professor in Pediatrics at Government Medical College, Jogulamba Gadwal, Telangana. She earned her MBBS (Bachelor of Medicine and Bachelor of Surgery) degree from Kakatiya Medical College, Warangal (2009) and completed her MD in Pediatrics from Niloufer Hospital, Osmania Medical College, Hyderabad (2013). Her areas of expertise include pediatric critical care and infectious diseases, with a strong academic interest in improving child health outcomes through evidence-based practices. She has contributed several publications to reputed national journals and is actively involved in clinical teaching, mentorship, and collaborative research aimed at strengthening pediatric healthcare delivery. ORCID iD: http://orcid.org/0009-0008-8473-201X

Dr. Ramya Madhuri Yendamuri , Associate Professor, Department of Pediatrics, Government Medical College and Hospital, Siddipet, Telangana, India

is an Associate Professor in the Department of Pediatrics at Government Medical College & Hospital, Siddipet, Telangana. She earned her MBBS (Bachelor of Medicine and Bachelor of Surgery) degree from Siddhartha Medical College (graduated in 2009) and subsequently pursued her MD in Pediatrics at Chalmeda Anand Rao Institute of Medical Sciences, completing it in 2016.

With an academic and clinical career grounded in evidence-based child health care, Dr. Ramya Madhuri is engaged in teaching, mentorship, and clinical supervision of undergraduate and postgraduate students. Her interests span neonatal care, growth and development, immunization strategies, and pediatric preventive medicine.ORCID iD: http://orcid.org/0009-0002-8316-0757

Dr. V. Murali Krishna , Professor, Department of Pediatrics, Niloufer Hospital, Osmania Medical College, Hyderabad, Telangana, India

is an accomplished pediatrician and academician with extensive clinical and teaching experience at Niloufer Hospital, one of the largest pediatric tertiary care centers in South India. He has been actively involved in undergraduate and postgraduate medical education, pediatric clinical services, and multidisciplinary research. His academic interests span neonatal and child health, infectious diseases, and preventive pediatrics. He has contributed to peer-reviewed publications, mentored postgraduate students, and continues to play a vital role in advancing pediatric healthcare and training in India.

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