THE MORTALITY OF DENGUE FEVER IN CARDIAC AND NON-CARDIAC PATIENTS

Abstract

Background: Dengue fever remains a major public health problem in tropical and subtropical regions, including Pakistan.

Objective: To determine the frequency of cardiac patients presenting with dengue fever and to compare the mortality rates of dengue fever in cardiac and non-cardiac patients.

Methods: This descriptive case series was conducted at October 2025 to January 2026. A total of 200 patients diagnosed with dengue fever (confirmed by NS1 antigen or IgM/IgG ELISA) were included. Patients were divided into two groups: those with pre-existing cardiac conditions (cardiac group) and those without (non-cardiac group). Data were collected prospectively, including demographics, dengue severity, treatment, and outcomes.

Results: Out of the 200 patients, 62 (31%) had pre-existing cardiac conditions, and 138 (69%) were non-cardiac. The mean age was significantly higher in cardiac patients (59.2 ± 10.1 years) than in non-cardiac patients (48.1 ± 12.9 years; p < 0.001). Severe dengue occurred in 56.4% of cardiac patients versus 36.2% of non-cardiac patients (p = 0.01). The overall mortality rate was 11%, with deaths significantly more frequent among cardiac patients (21%) compared to non-cardiac patients (6.5%) (p = 0.004). Multivariate logistic regression identified cardiac disease (OR = 3.92; 95% CI: 1.45–10.57; p = 0.007), severe dengue (OR = 4.28; 95% CI: 1.76–10.36; p = 0.001), and age > 55 years (OR = 2.17; 95% CI: 1.01–4.67; p = 0.046) as independent predictors of mortality.

Conclusion: It is concluded that dengue fever patients with pre-existing cardiac disease have a significantly higher mortality rate than those without cardiac involvement. Cardiac dysfunction, severe dengue, and advanced age were the strongest predictors of fatal outcomes.