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Gün E, Kendirli T, Öztürk AG, Botan E, Vatansever G, Arga G, Özdemir İ, Özdemir H, Tekin D, Çiftçi E, İnce E. Clinical Features and Outcomes of Children Admitted to the PICU due to Rotavirus Infection. Turk Arch Pediatr 2022; 56:591-595. [PMID: 35110058 PMCID: PMC8849640 DOI: 10.5152/turkarchpediatr.2021.21140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVES In this study, we aimed to evaluate the clinical and laboratory features of the patients with rotavirus (RV) antigen positivity on or following admission to the pediatric intensive care unit (PICU). METHODS Patients admitted to the PICU due to community-acquired rotavirus (CA-RV) or hospital-acquired rotavirus (HA-RV)-induced gastroenteritis between January 1, 2013, and December 31, 2019 were evaluated. RESULTS Thirty-four patients with a mean age of 14.00 ± 19.17 months were enrolled. Fortyfour percent were girls. Twenty (58.8%) patients had a history of chronic diseases. Nine (26.5%) patients had CA-RV and 25 (73.5%) patients had HA-RV infection. RV antigens were simultaneously found in 44.1% (n = 14) of the other patients at the time of diagnosis. In the study sample, 5 patients had hyponatremia, 8 had hypernatremia, 6 had hypokalemia, 4 had hypoalbuminemia, 21 had leukocytosis, 2 had leukopenia and 3 had thrombocytopenia, and 17 had elevatedC-reactive protein (CRP) levels. Three patients had seizures, 1 patient had cardiac arrest, and 2 patients had secondary bacteremia. The mean (SD) PICU length of stay was 6 (6.02) with CA-RV gastroenteritis. All CA-RV patients survived, but 8 of the HA-RV patients succumbed to causes other than RV. CONCLUSION RV-related PICU admission is not rare, and occasional severe clinical consequences occur, especially in young children, with both CA-RV and HA-RV gastroenteritis. Appropriate timely intervention and meticulous follow-up improve survival.
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Affiliation(s)
- Emrah Gün
- Department of Pediatrics, Division of Pediatric Critical Care Medicine, Ankara University School of Medicine, Ankara, Turkey
| | - Tanıl Kendirli
- Department of Pediatrics, Division of Pediatric Critical Care Medicine, Ankara University School of Medicine, Ankara, Turkey
| | - Ahmet Gökcan Öztürk
- Department of Pediatrics, Ankara University School of Medicine, Ankara, Turkey
| | - Edin Botan
- Department of Pediatrics, Division of Pediatric Critical Care Medicine, Ankara University School of Medicine, Ankara, Turkey
| | - Göksel Vatansever
- Department of Pediatrics, Division of Pediatric Emergency Medicine, Ankara University School of Medicine, Ankara, Turkey
| | - Gül Arga
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Ankara University School of Medicine, Ankara, Turkey
| | - İhsan Özdemir
- Department of Pediatrics, Division of Pediatric Emergency Medicine, Ankara University School of Medicine, Ankara, Turkey
| | - Halil Özdemir
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Ankara University School of Medicine, Ankara, Turkey
| | - Deniz Tekin
- Department of Pediatrics, Division of Pediatric Emergency Medicine, Ankara University School of Medicine, Ankara, Turkey
| | - Ergin Çiftçi
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Ankara University School of Medicine, Ankara, Turkey
| | - Erdal İnce
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Ankara University School of Medicine, Ankara, Turkey
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Dian Z, Sun Y, Zhang G, Xu Y, Fan X, Yang X, Pan Q, Peppelenbosch M, Miao Z. Rotavirus-related systemic diseases: clinical manifestation, evidence and pathogenesis. Crit Rev Microbiol 2021; 47:580-595. [PMID: 33822674 DOI: 10.1080/1040841x.2021.1907738] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Rotaviruses, double-stranded, non-enveloped RNA viruses, are a global health concern, associated with acute gastroenteritis and secretory-driven watery diarrhoea, especially in infants and young children. Conventionally, rotavirus is primarily viewed as a pathogen for intestinal enterocytes. This notion is challenged, however, by data from patients and animal models documenting extra-intestinal clinical manifestations and viral replication following rotavirus infection. In addition to acute gastroenteritis, rotavirus infection has been linked to various neurological disorders, hepatitis and cholestasis, type 1 diabetes, respiratory illness, myocarditis, renal failure and thrombocytopenia. Concomitantly, molecular studies have provided insight into potential mechanisms by which rotavirus can enter and replicate in non-enterocyte cell types and evade host immune responses. Nevertheless, it is fair to say that the extra-intestinal aspect of the rotavirus infectious process is largely being overlooked by biomedical professionals, and there are gaps in the understanding of mechanisms of pathogenesis. Thus with the aim of increasing public and professional awareness we here provide a description of our current understanding of rotavirus-related extra-intestinal clinical manifestations and associated molecular pathogenesis. Further understanding of the processes involved should prove exceedingly useful for future diagnosis, treatment and prevention of rotavirus-associated disease.
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Affiliation(s)
- Ziqin Dian
- Department of Clinical laboratory, The First People's Hospital of Yunnan province, Kunming, Yunnan, China
| | - Yi Sun
- Department of Clinical laboratory, The First People's Hospital of Yunnan province, Kunming, Yunnan, China
| | - Guiqian Zhang
- Department of Clinical laboratory, The First People's Hospital of Yunnan province, Kunming, Yunnan, China
| | - Ya Xu
- Department of Clinical laboratory, The First People's Hospital of Yunnan province, Kunming, Yunnan, China
| | - Xin Fan
- Department of Clinical laboratory, The First People's Hospital of Yunnan province, Kunming, Yunnan, China
| | - Xuemei Yang
- Department of Clinical laboratory, Kunming Children's Hospital, Kunming, Yunnan, China
| | - Qiuwei Pan
- Department of Gastroenterology and Hepatology, Erasmus MC-University Medical Center, Rotterdam, The Netherlands
| | - Maikel Peppelenbosch
- Department of Gastroenterology and Hepatology, Erasmus MC-University Medical Center, Rotterdam, The Netherlands
| | - Zhijiang Miao
- Department of Gastroenterology and Hepatology, Erasmus MC-University Medical Center, Rotterdam, The Netherlands
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