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Complications in hospitalized children with acute gastroenteritis caused by rotavirus: a retrospective analysis

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Abstract

Acute gastroenteritis (AGE) caused by rotavirus (RV) is a common disease among infants and toddlers, often leading to hospitalization and, in resource-poor countries, to death. However, little is known on specific complications of severe RV-positive (RV+) AGE and on the clinical course in chronically ill children. This was a retrospective analysis of data for children <5 years of age hospitalized due to AGE during six rotavirus seasons in three large German pediatric hospitals. The primary study end point was the incidence and type of complications in RV+ versus RV-negative (RV−) cases. A total of 6,884 episodes of AGE in hospitalized children aged <5 years were included in this analysis. Of the 4,880 stools tested for RV, 2,118 (43.4%) were RV+. Hypernatremia was significantly more common in RV+ AGE (P < 0.001) and was associated with severe disease, need for intensive care treatment, and longer duration of hospitalization. Metabolic disorders, particularly hypoglycemia, were more common in RV+ AGE. In contrast, symptoms such as respiratory infections, neurological, and abdominal symptoms were more common in children with RV− AGE. Conclusions: hypernatremia is a specific complication of RV+ AGE. RV would therefore appear to be the cause of infant toxicosis, the traditional descriptive term for severe dehydration and clinical deterioration following AGE.

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Acknowledgments

The authors thank Jennifer Coward, Independent Medical Writer, Bollington, UK, for the editorial assistance with the preparation of this manuscript and Werner Wosniok, Department of Biomedical Statistics, University of Bremen, Germany, for statistical counseling. Financial support for the study was provided by an unrestricted grant by GlaxoSmithKline Biologicals and Sanofi Pasteur MSD.

Conflict of interest

P. Kaiser received a grant for this study from GSK and Sanofi Pasteur, and speakers’ grants for lectures from both companies. M. Borte reports consultant fees from Pfizer, Novartis, GlaxoSmithKline, and Sanofi Pasteur MSD and support for scientific meetings from Pfizer, Abbott, AstraZenica, GlaxoSmithKline, and Sanofi Pasteur MSD. K.P. Zimmer is on the national advisory board on rotavirus vaccination for Sanofi Pasteur MSD. H.I. Huppertz has served as a consultant and obtained speaking fees from GSK and Sanofi Pasteur MSD.

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Authors and Affiliations

  1. Prof. Hess Kinderklinik, Klinikum Bremen-Mitte, St. Juergen-Strasse, 28205, Bremen, Germany

    Petra Kaiser & Hans-Iko Huppertz

  2. Kinderklinik, Klinikum St. Georg gGmbH Leipzig, Leipzig, Germany

    Michael Borte

  3. Universitätskinderklinik Giessen, Giessen, Germany

    Klaus-Peter Zimmer

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  1. Petra Kaiser
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  2. Michael Borte
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Correspondence to Hans-Iko Huppertz.

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Kaiser, P., Borte, M., Zimmer, KP. et al. Complications in hospitalized children with acute gastroenteritis caused by rotavirus: a retrospective analysis. Eur J Pediatr 171, 337–345 (2012). https://doi.org/10.1007/s00431-011-1536-0

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  • DOI: https://doi.org/10.1007/s00431-011-1536-0

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