Rotavirus-related systemic diseases: clinical manifestation, evidence and pathogenesis

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 rotavirusrelated 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.

Incident changes of rotavirus enteritis among children during the coronavirus disease-2019 pandemic in Hangzhou, China

“…As a double-stranded and non-enveloped ribonucleic acid virus, rotavirus is a major cause of life-threatening diarrhea in children worldwide, which was responsible for 29.3% of all diarrheal deaths among children under the age of 5 years in 2015 [2][3][4][5][6].…”

“…As a double-stranded and non-enveloped ribonucleic acid virus, rotavirus is a major cause of life-threatening diarrhea in children worldwide, which was responsible for 29.3% of all diarrheal deaths among children under the age of 5 years in 2015 [ 2 , 3 , 4 , 5 , 6 ]. Rotavirus enteritis greatly demonstrated pronounced seasonality and is typically considered a winter disease, especially in nonequatorial due to temperature and humidity changes that significantly affect rotavirus infection.…”

Rotavirus infection-associated central nervous system complications: clinicoradiological features and potential mechanisms

“…Benign convulsions with mild gastroenteritis are among the most common neurological manifestations related to rotavirus infection in children, occurring in approximately 1%-8% of patients with rotavirus gastroenteritis. 14,[31][32][33][34] Although it has been documented worldwide, the number of reported cases is considerably higher in East Asian countries, particularly Japan, Korea, Taiwan, and China. [21][22][23][35][36][37] This clinical condition is seen in previously healthy children aged 1 month to 6 years (peaking in 1-2-year-olds) and present with afebrile (or febrile) seizures that develop 1-6 days after gastroenteritis onset.…”

“…13) Rotavirus infection was initially considered confined to the gastrointestinal tract; however, many reports have shown that it may cause extra-intestinal manifestations including various neurological disorders, hepatitis, cholestasis, pancreatitis, type 1 diabetes, respiratory illness, myocarditis, renal failure, and thrombocytopenia. 14,15) Rotavirus is a common cause of acute encephalopathy and encephalitis in children. [16][17][18][19] Since the first report of central nervous system (CNS) involvement with rotavirus in 1978 (one fatal Reye's syndrome case, one encephalitis case), 20) a variety of rotavirus infection-associated CNS complications, such as convulsions with mild gastroenteritis, [21][22][23] aseptic meningitis, 24) mild encephalopathy with reversible splenial lesions, [25][26][27] encephalitis, 28,29) and cerebellitis, 30) have been documented.…”

High Prevalence of Common Human Viruses in Thyroid Tissue

“…Case reports and autopsy studies show further associations of AITD with viral infections: rubella virus in congenital illness ( 30 ), human T cell leukemia virus ( 31 ), Hantaan virus ( 32 ), hepatitis E virus ( 33 ), HIV ( 34 ) and – more recently – the Severe Acute Respiratory Syndrome Coronavirus-2 ( 35 – 39 ). In addition, various gastroenteric viruses have been detected in children with other autoimmune disorders such as celiac disease and type 1 diabetes ( 40 , 41 ).…”