Hepatic damage associated with dengue infection: insights from the emergency department of a tertiary care centre

Liver involvement is a common but variable manifestation of dengue virus infection. This study aimed to evaluate the clinical and biochemical spectrum of dengue hepatitis and its correlation with disease severity in patients presenting to a tertiary care center. A retrospective cross-sectional study was conducted at a tertiary care center from July 2024 to December 2024, including 130 adult patients with laboratory-confirmed dengue infection. Dengue hepatitis was categorized as mild, moderate, or severe based on serum transaminase levels. Disease severity was assessed according to both the World Health Organization (WHO) 1997 and WHO 2009 classification criteria. Laboratory parameters were analyzed in relation to hepatitis severity. Among the 130 patients, 113 (87%) had elevated liver enzymes. Aspartate Aminotransferase Levels (AST) were consistently higher than Alanine Aminotransferase (ALT). Severe dengue hepatitis was significantly associated with WHO 2009 disease severity classification (p<0.001). Total bilirubin levels were significantly elevated in patients with more severe hepatitis, while no significant correlation was observed between platelet count and hepatitis severity. Patients presenting with warning signs and severe dengue had higher frequencies of moderate-to-severe hepatitis. We conclude that hepatic involvement in dengue infection is common and correlates with disease severity. Elevated transaminases, particularly AST, and rising bilirubin levels may serve as early markers of severe dengue. Integration of liver function monitoring into clinical assessment protocols is essential for the timely management of dengue hepatitis.