Correlation of severity of dengue with serum aminotransferase levels


  • Syed Javed Department of General Medicine, Geetanjali Medical College and Hospital, Udaipur, Rajasthan, India
  • Prabhat Singh Department of General Medicine, Geetanjali Medical College and Hospital, Udaipur, Rajasthan, India
  • Sanjay Kumar Paliwal Department of General Medicine, Geetanjali Medical College and Hospital, Udaipur, Rajasthan, India



Bleeding tendency, Dengue, Liver function test, Serum aminotransferase, Shock


Background: In dengue, association of fever (most common presenting symptom) with hepatic involvement can be relatively more serious. Such patients may have raised serum aminotransferase levels as well as can be more prone to bleeding due to deranged liver functions. Thus, the present study was conducted with an objective to correlate these enzyme levels with the severity of dengue fever.

Methods: This prospective, observational study was carried out for 1.5 years at a tertiary care teaching hospital in southern Rajasthan after ethics committee approval. Those patients diagnosed with dengue, admitted at this tertiary centre, aged 18 years and above and willing to give consent for participation, were included in the study. Patients were assessed for clinical features of dengue along with both laboratory and radiological investigations. Severity of dengue was correlated with aminotransferase levels. Data analysis was carried out using appropriate statistical tests.

Results: Total 200 patients were analysed. Mean age was 36.92±14 years while male: female ratio was 1.23:1 in the study population. All patients (100%) had fever whereas shock and bleeding tendency were noted in 16 (8%) and 4 (2%) patients respectively. Majority 130 (65%) patients had moderate dengue. Raised aminotransferase levels were noted in approximately 65% study patients out of which nearly 40% patients had moderate dengue. Correlation of raised aminotransferase levels with thrombocytopenia, shock, bleeding tendency were not statistically significant. 

Conclusions: Serum aminotransferase levels were elevated in moderate dengue patients. However, there was no significant correlation of raised enzyme levels with thrombocytopenia, presence of shock and bleeding tendency or as the severity of dengue increases. Thus, it is quite subjective whether to predict severity of dengue from raised enzyme levels or not.


World Health Organization (WHO). Dengue and severe dengue. 2020 June 23. Available from: Accessed on 31st Jan 2021.

Kulkarni V, Koppad B, Shetty MU. Profile of serum transaminases in patients with dengue infection in a tertiary care hospital. Int J Contem Pediatr. 2018;5(1):23-6.

Villar-Centeno LA, Diaz-Quijano FA, Martinez-Vega RA. Biochemical alterations as markers of dengue haemorrhagic fever. Am J Trop Med Hygiene. 2008;78:370-4.

Jnaneshwari M, Jayakumar S, Kumar A, Uday G. Study of Serum Aminotransferase Levels in Dengue Fever. J Evol Medi Dental Sci. 2014;3(10):2445-55.

Biswas A, Pangtey G, Devgan V, Singla P, Murthy P, Dhariwal AC et al. Indian National Guidelines for Clinical Management of Dengue Fever. J Indian Med Assoc. 2015;113(12):196-206.

Lala V, Goyal A, Bansal P, Minter DA. Liver Function Tests. In: StatPearls. 2020 Jul 4. Available at: 489/. Accessed on 2nd February 2021.

International Association for Medical Assistance to Travellers (IAMAT). India General Health Risks: Dengue. 2020 Dec 8. Available from: Accessed on 3rd Feb 2021.

Verma AK, Prabhakar K, Reddy P. Correlation of Severity of Dengue Fever with Serum Transaminase Levels: A Retrospective Study. J Med Sci Clin Res. 2017;5(11):30720-4.

Pandey S, Pandey S. Study of dengue fever in South Eastern Rajasthan. J Evolution Med Dental Sci. 2015;4(11):1836-41.

Ayaz F, Muhammad F. Assessment of Severity of Dengue Fever by Deranged Alanine Aminotransferase Levels. Cureus. 2020;12(9):e10539.

Anker M, Arima Y. Male-female differences in the number of reported incident dengue fever cases in six Asian countries. Western Pacific Surveillance Response J. 2011;2(2):17-23.

Balakumar J, Balasubramaniyan S, Paari N. Study of serum aminotransferase levels in dengue fever and its correlation. J Med Sci Clin Res. 2019;7(11):36-41.

Souza LJ, Alves JG, Nogueira RM, Neto CG, Bastos DA, Siqueira EWS, et al. Aminotransferase changes and acute hepatitis in patients with dengue fever: analysis of 1,585 cases. Brazilian J Infect Dis. 2004;8(2):156-63.

Mukker P, Kiran S. Platelet indices evaluation in patients with dengue fever. Int J Res Med Sci. 2018;6(6):2054.

Wahid SF, Sansui S, Zawawi MM, Ali RA. A comparison of the pattern of liver involvement in dengue hemorrhagic fever with classical dengue fever. Southeast Asian J Trop Med Public Health. 2000;31(2):259-63.

Chhina RS, Goyal O, Chhina DK, Goyal P, Kumar R, Puri S. Liver function tests in patients with dengue viral infection. Dengue Bull. 2008,32:110-7.

Chaudhuri NG, Vithyavathi S, Sankar K. Clinical and laboratory profile of different dengue sub types in dengue virus infection. Int J Res Med Sci. 2016;4(3):743-8.






Original Research Articles