A prospective observational study of cardiac involvement during dengue infection at a tertiary care hospital in Sri Lanka

Abstract

Introduction: Dengue virus infection causes high mortality and morbidity and imposes an economic burden in Sri Lanka. Currently, there is insufficient data on the prevalence and associated factors of cardiac involvement in dengue viral infection in Sri Lanka.

Methodology: A total of 220 patients admitted with dengue viral infection to the National Hospital of Sri Lanka, between July and September 2025, participated in this study. Patients were evaluated for cardiac involvement based on highly sensitive Troponin I positivity and dynamic Electrocardiogram (ECG) changes. Cardiac involvement was stratified into subgroups: Troponin I positivity only, ECG changes only, and both.

Results: Out of the 220 patients enrolled in the study, 126 (57.27%) were male, and 94 (42.73%) were female. The mean age was 35.02 (± 14.84 SD). Troponin I positivity only was seen in 11 (5.00%) patients, and ECG changes only were seen in 28 (12.73%) of patients. 8 (3.63%) had both changes. In total, 47 patients (21.36%) had ECG changes and/or Troponin I positivity. Patients with these changes had significantly higher AST (p = 0.0287), lower platelet counts (p = 0.003), a higher proportion of diabetes mellitus (p = 0.041), and hypertension (p = 0.0074).

Conclusions: In this study, 21.36% of the population had evidence of cardiac involvement, as indicated by ECG changes or Troponin I positivity. Higher AST levels, lower platelet counts, dengue hemorrhagic fever and the presence of comorbidities such as diabetes mellitus and hypertension were recognized as possible associated factors of cardiac involvement by this study.