Revised Study Report: Electrolyte Imbalance and its Association with the Severity of Dengue Fever in a Peripheral Tertiary Care Center

Abstract

Objective: To evaluate patterns of electrolyte imbalance in pediatric patients presenting with dengue fever, dengue with warning signs, and severe dengue, and to correlate these disturbances with disease severity and clinical outcomes in a peripheral tertiary care setting. Study Design: Cross-sectional observational study. Setting: Department of Pediatrics, Koppal Institute of Medical Sciences (KIMS), Koppal, Karnataka, India. Period anuary 2025 to june 2026. Methods: A total of 70 pediatric patients aged 6 months to 12 years with serologically confirmed dengue (NS1 antigen or IgM ELISA positive) were enrolled using non-probability consecutive sampling. Demographic, clinical, and laboratory parameters were evaluated. Patients were categorized according to WHO dengue severity criteria. Serum sodium, potassium, calcium, levels were measured and analyzed using IBM SPSS v24. Chi-square test and ANOVA were applied, with p < 0.05 considered statistically significant. Results: Among 70 children (mean age 5.1 \pm 3.5 years; 51.4% male), 18 (25.7%) had dengue fever, 40 (57.1%) had dengue with warning signs, and 12 (17.1%) had severe dengue. Hyponatremia was present in 25 (35.7%) children, occurring most frequently in dengue with warning signs (45.0%) and severe dengue (41.7%) (p < 0.001). Hypernatremia was exclusively identified in severe dengue cases (25.0%, p < 0.001). Hypokalemia and hypocalcemia were observed in 20.0% (n = 14) and 58.6% (n = 41) of children,all were successfully stabilized, managed, and discharged following timely targeted electrolyte correction and fluid therapy. Conclusion: Electrolyte disturbances, particularly hyponatremia, hypernatremia, and hypocalcemia, are highly prevalent in pediatric dengue and strongly correlate with disease severity. Early routine monitoring and prompt electrolyte restoration prevent disease progression, achieving complete recovery and eliminating mortality even in severe dengue presentations in peripheral medical settings.