Factores de riesgo de gravedad, hospitalización y mortalidad por dengue en adultos mayores: una revisión sistemática

Introduction. Dengue is the arboviral disease with the greatest global impact and presented a recent age shift of disease burden toward the elderly. This phenomenon is exacerbated by immunosenescence and high prevalence of chronic multimorbidity, characterizing a syndemic scenario that drastically increases this population’s vulnerability to fatal outcomes.Objective. To identify and synthesize clinical, laboratory, and sociodemographic factors associated with dengue severity, hospitalization, and mortality in people aged 60 years or older.Materials and methods. Systematic review (PRISMA 2020) in PubMed, LILACS, Scopus, and Web of Science databases (2015–2025). Analytical observational studies evaluated using Newcastle-Ottawa Scale (NOS) were included.Results. Of the 48 studies included, 26 comprised the analytical core. The risk of severe disease increases with age, reaching a critical level at 80 years or older (aOR 3.10; 95% CI: 2.02–4.92). Predictors of death included male sex, low educational level, and black (OR 1.58; 95% CI: 1.06–2.32) or indigenous persons. In the syndemic context, Diabetes Mellitus (aOR 19.40; 95% CI: 16.80–22.42 for hemorrhage) and chronic kidney disease (OR 6.64; 95% CI: 3.81–11.58 for death) presented the greatest prognostic impact. Predictors such as qSOFA score of 2 (OR 18.74; 95% CI: 4.37–50.64) and altered consciousness (aOR 11.68; 95% CI: 2.83–48.16) outperformed conventional WHO warning signs in predicting mortality.Conclusion. Dengue in the elderly population is characterized by high case-fatality rates, atypical manifestations, and a strong influence of socio-structural inequities. This group must be prioritized in vaccination strategies and health equity policies.