The etiology of viral gastroenteritis in patients requiring hospitalization: Differences between rotavirus and norovirus infections - practical or only academic significance?

Abstract

Introduction/Objective. Viral gastroenteritides (VGEs) have great infectious potential and may occur in all age groups. Loss of fluid due to vomiting and diarrhea represent a special risk, and may result in a more severe clinical presentation in children, the elderly, and people with chronic diseases. The aim of the study was to explore the causes of VGEs among hospitalized patients, as well as to evaluate the severity of clinical symptoms in rotavirus and norovirus infections. Methods. The observational prospective study included 191 patients aged 2–88 years who were treated at the Clinic for Infectious Diseases, Clinical Center of Vojvodina, Novi Sad, over a two-year period. Testing of stool samples for viral agents was done by the reverse-transcription polymerase chain reaction method. Positive findings were found in 59 patients. Results. Of 59 patients with confirmed viral gastroenteritis, in 31 (52.5%) it was caused by rotavirus, in 17 (28.8%) by norovirus, three patients (5.1%) had other viral causes, while co-infection with two viruses was found in eight (13.5%) patients. The severity of clinical manifestations as expressed with Vesikari score did not differ with regard to infectious agents (p = 0.353). However, patients with rotavirus infection had a higher incidence of fever (p = 0.043), longer duration of diarrhea (p = 0.015) and dehydration (p = 0.014), and longer need for hospital treatment (p = 0.030). Conclusion. The most common cause of VGEs in our hospitalized patients was rotavirus. There was no difference in the severity of clinical symptoms between rotavirus and norovirus infections.

Keywords

• norovirus
• rotavirus
• gastroenteritis
• hospitalization
• length of stay