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Role of neutrophil-to-lymphocyte, mean platelet volume-to-platelet and platelet-to-lymphocyte ratios as predictors of disease severity in Rotavirus gastroenteritis

Year 2022, , 280 - 287, 26.09.2022
https://doi.org/10.47582/jompac.1168976

Abstract

Aim: In developing countries, Rotavirus Gastroenteritis (RG) is even now one of the most common causes of death and morbidity. As a result, clinicians must be extremely vigilant in detecting the presence and severity of RG. The goal of this study was to identify predictors of RG severity by analyzing complete blood counts, including neutrophil-to-lymphocyte ratio (NLR), mean platelet volume-to-platelet volume (MPV/P); platelet-to-lymphocyte ratio (PLR).
Material and Method: Data were obtained retrospectively from medical records of 456 children diagnosed with RG and age-matched healthy children from University of Health and Sciences, Ankara Atatürk Sanatorium Training and Research Hospital between January 2019 and December 2021. The Vesikari Score was used to categorize disease severity as severe or mild. Variables’ prognostic effects on disease severity were equated across groups.
Results: The study included 456 children with RG. Two hundred thirty two of them were severe; 126 males; median age: 1.24 (0.41-2.36 years), 224 of them non-severe; 126 males; median age 1.52 (1.01-2.84 years). The median length of hospitalization was 5 (4-7) days for the severe group and 2 (0-3) days for the non-severe group (p<0.001). Neutrophils, monocyte, platelet, red cell distribution width, NLR, and PLR levels in RG patients were statistically significantly higher than in the control group, while hemoglobin, platelet distribution width, MPV, and MPV/P levels were lower (p<0.001). The area under the operating characteristic curve (AUC) for NLR, and MPV/P for severe disease was calculated as (0.556; and 0.709, respectively), and was all statistically significant (p<0.001). However, PLR was not found statistically significant in ROC analysis (p>0.001).
Conclusion: NLR was increased and MPV/P was decreased with the increase in severity of Rotavirus Gastroenteritis. NLR and MPV/P were useful for providing additional severity stratification in RG.

References

  • Tate JE, Burton AH, Boschi-Pinto C, Steele AD, Duque J, Parashar UD 2008 estimate of worldwide rotavirus-associated mortality in children younger than 5 years before the introduction of universal rotavirus vaccination programmes: a systematic review and meta-analysis. Lancet Infect Dis 2012; 12: 136–41.
  • Gilger MA, Matson DO, Conner ME, Rosenblatt HM, Finegold MJ, Estes MK. Extraintestinal rotavirus infections in children with immunodeficiency. J Pediatr 1992; 120: 912–7.
  • Santosham M, Yolken RH, Quiroz E, et al. Detection of rotavirus in respiratory secretions of children with pneumonia. J Pediatr 1983; 103: 583-5.
  • Limbos MA, Lieberman JM. Disseminated intravascular coagulation associated with rotavirus gastroenteritis: report of two cases. Clin Infect Dis 1996; 22: 834-6.
  • Pang XL, Joensuu J, Vesikari T. Detection of rotavirus RNA in cerebrospinal fluid in a case of rotavirus gastroenteritis with febrile seizures. Pediatr Infect Dis J 1996; 15: 543-5.
  • Ruzicka T, Rosendahl C, Braun-Falco O. A probable case of rotavirus exanthem. Arch Dermatol 1985; 121: 253-4.
  • Takahashi S, Oki J, Miyamoto A, et al. Encephalopathy associated with haemophagocytic lymphohistiocytosis following rotavirus infection. Eur J Pediatr 1999; 158: 133–7.
  • Ramby AL, Goodman DM, Wald EL, Weiss SL. Red blood cell distribution width as a pragmatic marker for outcome in pediatric critical illness. PLoS One 2015; 10: e0129258.
  • Vélez-Páez JL, Legua P, Vélez-Páez P, et al. Mean platelet volume and mean platelet volume to platelet count ratio as predictors of severity and mortality in sepsis. PLoS One 2022; 17: e0262356.
  • Gul A, Takçı Ş, Seyyah BA, Yılmaz R. Independent predictors of severity and hospitalization in acute bronchiolitis: neutrophil/lymphocyte ratio and mean platelet volume. J Pediatr Infect Dis 2018; 13: 268-73.
  • Golwala ZM, Shah H, Gupta N, Sreenivas V, Puliyel JM. Mean platelet volume (MPV), platelet distribution width (PDW), platelet count and plateletcrit (PCT) as predictors of in-hospital paediatric mortality: a case-control Study Afr Health Sci 2016; 16: 356-62.
  • Gasparyan AY, Ayvazyan L, Mukanova U, Yessirkepov M, Kitas GD. The Platelet-to-lymphocyte ratio as an inflammatory marker in rheumatic diseases. Ann Lab Med 2019; 39: 345–57.
  • Zhang S, Luan X, Zhang W, Jin Z. Platelet-to-lymphocyte and neutrophil-to-lymphocyte ratio as predictive biomarkers for early-onset neonatal sepsis. J Coll Physicians Surg Pak 2021; 30: 821-4.
  • Ruuska T, Vesikari T. Rotavirus disease in Finnish children: use of numerical scores for clinical severity of diarrhoeal episodes. Scand J Infect Dis 1990; 22: 259-67.
  • Kim A, Chang JY, Shin S, et al. Epidemiology and factors related to clinical severity of acute gastroenteritis in hospitalized children after the introduction of rotavirus vaccination. J Korean Med Sci 2017; 32: 465-74.
  • Ojobor CD, Olovo CV, Onah LO, Ike AC. Prevalence and associated factors to rotavirus infection in children less than 5 years in Enugu State, Nigeria. Virusdisease 2020; 31: 316–22.
  • ‌Korkmaz MF, Tutanç M, Bostancı M, Korkmaz M, Salihoğlu TE. Red blood cell distribution width as a useful marker for severity in pediatric acute gastroenteritis. Pediatr Int 2019; 61: 1109-13.
  • Qadori M, Flem E, Bekkevold T, et al. Hypoglycaemia was common in acute gastroenteritis in a prospective hospital-based study, but electrolyte imbalances were not. Acta Paediatr 2018; 107: 1455-60.
  • ‌Singh M, Sankar J, Kumar A, Kumar UV, Lodha R, Kabra SK. Predictors of mortality in children admitted to the pediatric intensive care unit with acute gastroenteritis with severe dehydration. Indian J Pediatr 2019; 86: 1142-5.
  • ‌Foldenauer A, Vossbeck S, Pohlandt F. Neonatal hypocalcaemia associated with rotavirus diarrhoea. Eur J Pediatr 1998; 157: 838-42.
  • ‌Yeom JS, Kim YS, Park JS, et al. Role of Ca2+ homeostasis disruption in rotavirus-associated seizures. J Child Neurol 2014; 29: 331-5.
  • ‌Akelma AZ, Kütükoğlu I, Köksal T, et al. Serum transaminase elevation in children with rotavirus gastroenteritis: seven years’ experience. Scand J Infect Dis 2013; 45: 362-7.
  • ‌Teitelbaum JE, Daghistani R. Rotavirus causes hepatic transaminase elevation. Dig Dis Sci 2007; 52: 3396-8.
  • Kawashima H, Ishii C, Ioi H, Nishimata S, Kashiwagi Y, Takekuma K. Transaminase in rotavirus gastroenteritis. Pediatr Int 2012; 54: 86-8.
  • Işik I, Tokgöz Y, Erdur B, Arslan N. Aminotransferase elevations in rotavirus positive and negative acute gastroenteritis and its relation with disease severity. Minerva Pediatr 2017; 69: 36-41.
  • Sadaka F, O’Brien J, Prakash S. Red cell distribution width and outcome in patients with septic shock. J Intensive Care Med 2013; 28: 307-13.
  • Ku NS, Kim HW, Oh HJ, et al. Red blood cell distribution width is an independent predictor of mortality in patients with gram-negative bacteremia. Shock 2012; 38: 123-7.
  • ‌Bazick HS, Chang D, Mahadevappa K, Gibbons FK, Christopher KB. Red cell distribution width and all-cause mortality in critically ill patients*. Crit Care Med 2011 ; 39: 1913–21.
  • Azab B, Torbey E, Singh J, et al. Mean platelet volume/platelet count ratio as a predictor of long-term mortality after non-ST-elevation myocardial infarction. Platelets 2011; 22: 557-66.
  • Mete E, Akelma AZ, Cizmeci MN, Bozkaya D, Kanburoglu MK. Decreased mean platelet volume in children with acute rotavirus gastroenteritis. Platelets 2014; 25: 51-4.
  • Tanju C, Ekrem G, Berksoy Emel A, Nur A. Mean platelet volume as a negative marker of inflammation in children with rotavirus gastroenteritis. Iran J Pediatr 2014; 24: 617-22.
  • Azim T, Zaki MH, Podder G et al. Rotavirus-specific subclass anti-body and cytokine responses in Bangladeshi children with rotavirus diarrhoea. J Med Virol 2003; 69: 286–95.
  • Wang Y, Dennehy PH, Keyserling HL et al. Rotavirus infection alters peripheral T-cell homeostasis in children with acute diarrhea. J Virol 2007; 81: 3904–12.
  • Liakopoulou E, Mutton K, Carrington D et al. Rotavirus as a significant cause of prolonged diarrhoeal illness and morbidity following allogeneic bone marrow transplantation. Bone Marrow Transplant 2005; 36: 691–4.
  • Zahorec R. Ratio of neutrophil to lymphocyte counts--rapid and simple parameter of systemic inflammation and stress in critically ill. Bratisl Lek Listy 2001; 102: 5-14.
  • Zhang C, Li G, Zhang H, Zhang H, Fei Y. Decreased lymphocyte to monocyte ratio and increased neutrophil to lymphocyte ratio observed in rotavirus-positive acute gastroenteritis in children: a retrospective study. Ann Clin Lab Sci 2020; 50: 450-6.
  • Samuel D, Bhat AN, Prabhu VM. Platelet indices as predictive markers of prognosis in critically ill patients: a prospective study. Indian J Crit Care Med 2020; 24: 817–22.

Rotavirüs gastroenteritinin şiddetin belirlenmesinde nötrofil lenfosit, ortamala trombosit hacmi trombosit ve trombosit lenfosit oranlarının rolü

Year 2022, , 280 - 287, 26.09.2022
https://doi.org/10.47582/jompac.1168976

Abstract

Amaç: Gelişmekte olan ülkelerde Rotavirus gastroenteriti (RG) günümüzde bile en yaygın ölüm ve morbidite nedenlerinden biridir. Sonuç olarak, klinisyenler RG’nin varlığını ve ciddiyetini tespit etmede son derece uyanık olmalıdır. Bu çalışmanın amacı, nötrofil lenfosit oranı (NLO), ortalama trombosit hacmi trombosit oranı (OTH/T) ve trombosit lenfosit oranı (TLO) dahil olmak üzere tam kan sayımlarını analiz ederek RG şiddetinin öngörücülerini belirlemekti.
Gereç ve Yöntem: Veriler, Ocak 2019 ile Aralık 2021 tarihleri arasında Sağlık Bilimleri Üniversitesi, Ankara Atatürk Sanatoryum Eğitim ve Araştırma Hastanesinde de RG tanısı konan 456 çocuğun tıbbi kayıtlarından ve aynı yaştaki sağlıklı çocukların tıbbi kayıtlarından geriye dönük olarak elde edildi. Hastalık şiddetini; şiddetli veya hafif kategorize etmek için Vesikari skoru kullanıldı. Değişkenlerin hastalık şiddeti üzerindeki prognostik etkileri gruplar arasında karşılaştırıldı.
Bulgular: Çalışmaya RG’lı 456 çocuk dahil edildi. Bunlardan iki yüz otuz ikisi şiddetliydi; 126 erkek; medyan yaş: 1,24 (0,41-2,36) yıl, 224’ü şiddetli değil; 126 erkek; medyan yaş 1,52 (1,01-2,84) yıldı. Hastanede medyan kalış süresi ağır grup için 5 (4-7) gün ve ağır olmayan grup için 2 (0-3) gündü (p<0,001). RG hastalarında nötrofil, monosit, trombosit, eritrosit dağılım genişliği, NLO ve TLO düzeyleri kontrol grubuna göre istatistiksel olarak anlamlı derecede yüksek, hemoglobin, trombosit dağılım genişliği, OTH ve OTH/T düzeyleri ise daha düşüktü (p<0,001). ROC analizinde; NLO ve OTH/T için operasyon karakteristik eğrisi (AUC) altında kalan alan, şiddetli hastalık için (sırasıyla 0,556 ve 0,709) olarak hesaplandı ve tümü istatistiksel olarak anlamlıydı (p<0,001) fakat TLO ​​istatistiksel olarak anlamlı bulunmadı (p>0,001).
Sonuç: Rotavirüs Gastroenteritinin şiddetinin artmasıyla NLO artmış ve OTH/T azalmıştır. NLO ve OTH/T, RG’de ek şiddet sınıflandırma sağlamak için faydalı bulunmuştur.

References

  • Tate JE, Burton AH, Boschi-Pinto C, Steele AD, Duque J, Parashar UD 2008 estimate of worldwide rotavirus-associated mortality in children younger than 5 years before the introduction of universal rotavirus vaccination programmes: a systematic review and meta-analysis. Lancet Infect Dis 2012; 12: 136–41.
  • Gilger MA, Matson DO, Conner ME, Rosenblatt HM, Finegold MJ, Estes MK. Extraintestinal rotavirus infections in children with immunodeficiency. J Pediatr 1992; 120: 912–7.
  • Santosham M, Yolken RH, Quiroz E, et al. Detection of rotavirus in respiratory secretions of children with pneumonia. J Pediatr 1983; 103: 583-5.
  • Limbos MA, Lieberman JM. Disseminated intravascular coagulation associated with rotavirus gastroenteritis: report of two cases. Clin Infect Dis 1996; 22: 834-6.
  • Pang XL, Joensuu J, Vesikari T. Detection of rotavirus RNA in cerebrospinal fluid in a case of rotavirus gastroenteritis with febrile seizures. Pediatr Infect Dis J 1996; 15: 543-5.
  • Ruzicka T, Rosendahl C, Braun-Falco O. A probable case of rotavirus exanthem. Arch Dermatol 1985; 121: 253-4.
  • Takahashi S, Oki J, Miyamoto A, et al. Encephalopathy associated with haemophagocytic lymphohistiocytosis following rotavirus infection. Eur J Pediatr 1999; 158: 133–7.
  • Ramby AL, Goodman DM, Wald EL, Weiss SL. Red blood cell distribution width as a pragmatic marker for outcome in pediatric critical illness. PLoS One 2015; 10: e0129258.
  • Vélez-Páez JL, Legua P, Vélez-Páez P, et al. Mean platelet volume and mean platelet volume to platelet count ratio as predictors of severity and mortality in sepsis. PLoS One 2022; 17: e0262356.
  • Gul A, Takçı Ş, Seyyah BA, Yılmaz R. Independent predictors of severity and hospitalization in acute bronchiolitis: neutrophil/lymphocyte ratio and mean platelet volume. J Pediatr Infect Dis 2018; 13: 268-73.
  • Golwala ZM, Shah H, Gupta N, Sreenivas V, Puliyel JM. Mean platelet volume (MPV), platelet distribution width (PDW), platelet count and plateletcrit (PCT) as predictors of in-hospital paediatric mortality: a case-control Study Afr Health Sci 2016; 16: 356-62.
  • Gasparyan AY, Ayvazyan L, Mukanova U, Yessirkepov M, Kitas GD. The Platelet-to-lymphocyte ratio as an inflammatory marker in rheumatic diseases. Ann Lab Med 2019; 39: 345–57.
  • Zhang S, Luan X, Zhang W, Jin Z. Platelet-to-lymphocyte and neutrophil-to-lymphocyte ratio as predictive biomarkers for early-onset neonatal sepsis. J Coll Physicians Surg Pak 2021; 30: 821-4.
  • Ruuska T, Vesikari T. Rotavirus disease in Finnish children: use of numerical scores for clinical severity of diarrhoeal episodes. Scand J Infect Dis 1990; 22: 259-67.
  • Kim A, Chang JY, Shin S, et al. Epidemiology and factors related to clinical severity of acute gastroenteritis in hospitalized children after the introduction of rotavirus vaccination. J Korean Med Sci 2017; 32: 465-74.
  • Ojobor CD, Olovo CV, Onah LO, Ike AC. Prevalence and associated factors to rotavirus infection in children less than 5 years in Enugu State, Nigeria. Virusdisease 2020; 31: 316–22.
  • ‌Korkmaz MF, Tutanç M, Bostancı M, Korkmaz M, Salihoğlu TE. Red blood cell distribution width as a useful marker for severity in pediatric acute gastroenteritis. Pediatr Int 2019; 61: 1109-13.
  • Qadori M, Flem E, Bekkevold T, et al. Hypoglycaemia was common in acute gastroenteritis in a prospective hospital-based study, but electrolyte imbalances were not. Acta Paediatr 2018; 107: 1455-60.
  • ‌Singh M, Sankar J, Kumar A, Kumar UV, Lodha R, Kabra SK. Predictors of mortality in children admitted to the pediatric intensive care unit with acute gastroenteritis with severe dehydration. Indian J Pediatr 2019; 86: 1142-5.
  • ‌Foldenauer A, Vossbeck S, Pohlandt F. Neonatal hypocalcaemia associated with rotavirus diarrhoea. Eur J Pediatr 1998; 157: 838-42.
  • ‌Yeom JS, Kim YS, Park JS, et al. Role of Ca2+ homeostasis disruption in rotavirus-associated seizures. J Child Neurol 2014; 29: 331-5.
  • ‌Akelma AZ, Kütükoğlu I, Köksal T, et al. Serum transaminase elevation in children with rotavirus gastroenteritis: seven years’ experience. Scand J Infect Dis 2013; 45: 362-7.
  • ‌Teitelbaum JE, Daghistani R. Rotavirus causes hepatic transaminase elevation. Dig Dis Sci 2007; 52: 3396-8.
  • Kawashima H, Ishii C, Ioi H, Nishimata S, Kashiwagi Y, Takekuma K. Transaminase in rotavirus gastroenteritis. Pediatr Int 2012; 54: 86-8.
  • Işik I, Tokgöz Y, Erdur B, Arslan N. Aminotransferase elevations in rotavirus positive and negative acute gastroenteritis and its relation with disease severity. Minerva Pediatr 2017; 69: 36-41.
  • Sadaka F, O’Brien J, Prakash S. Red cell distribution width and outcome in patients with septic shock. J Intensive Care Med 2013; 28: 307-13.
  • Ku NS, Kim HW, Oh HJ, et al. Red blood cell distribution width is an independent predictor of mortality in patients with gram-negative bacteremia. Shock 2012; 38: 123-7.
  • ‌Bazick HS, Chang D, Mahadevappa K, Gibbons FK, Christopher KB. Red cell distribution width and all-cause mortality in critically ill patients*. Crit Care Med 2011 ; 39: 1913–21.
  • Azab B, Torbey E, Singh J, et al. Mean platelet volume/platelet count ratio as a predictor of long-term mortality after non-ST-elevation myocardial infarction. Platelets 2011; 22: 557-66.
  • Mete E, Akelma AZ, Cizmeci MN, Bozkaya D, Kanburoglu MK. Decreased mean platelet volume in children with acute rotavirus gastroenteritis. Platelets 2014; 25: 51-4.
  • Tanju C, Ekrem G, Berksoy Emel A, Nur A. Mean platelet volume as a negative marker of inflammation in children with rotavirus gastroenteritis. Iran J Pediatr 2014; 24: 617-22.
  • Azim T, Zaki MH, Podder G et al. Rotavirus-specific subclass anti-body and cytokine responses in Bangladeshi children with rotavirus diarrhoea. J Med Virol 2003; 69: 286–95.
  • Wang Y, Dennehy PH, Keyserling HL et al. Rotavirus infection alters peripheral T-cell homeostasis in children with acute diarrhea. J Virol 2007; 81: 3904–12.
  • Liakopoulou E, Mutton K, Carrington D et al. Rotavirus as a significant cause of prolonged diarrhoeal illness and morbidity following allogeneic bone marrow transplantation. Bone Marrow Transplant 2005; 36: 691–4.
  • Zahorec R. Ratio of neutrophil to lymphocyte counts--rapid and simple parameter of systemic inflammation and stress in critically ill. Bratisl Lek Listy 2001; 102: 5-14.
  • Zhang C, Li G, Zhang H, Zhang H, Fei Y. Decreased lymphocyte to monocyte ratio and increased neutrophil to lymphocyte ratio observed in rotavirus-positive acute gastroenteritis in children: a retrospective study. Ann Clin Lab Sci 2020; 50: 450-6.
  • Samuel D, Bhat AN, Prabhu VM. Platelet indices as predictive markers of prognosis in critically ill patients: a prospective study. Indian J Crit Care Med 2020; 24: 817–22.
There are 37 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Research Articles [en] Araştırma Makaleleri [tr]
Authors

Deniz Güven 0000-0002-4293-910X

Dilek Sarici 0000-0002-7671-3010

Publication Date September 26, 2022
Published in Issue Year 2022

Cite

AMA Güven D, Sarici D. Role of neutrophil-to-lymphocyte, mean platelet volume-to-platelet and platelet-to-lymphocyte ratios as predictors of disease severity in Rotavirus gastroenteritis. J Med Palliat Care / JOMPAC / Jompac. September 2022;3(3):280-287. doi:10.47582/jompac.1168976

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