Age characteristics of the course of rotavirus infection in children and the contribution of the osmotic component in the pathogenesis of the diarrhea syndrome depending on age

Abstract

Purpose - to identify the age-specific features of the course of rotavirus infection (RVI) in children and to clarify the role of the osmolar component in the pathogenesis of diarrheal syndrome in young children.

Materials and methods. 100 young children with RVI were examined. Children were divided into 3 age subgroups: 1-6 months, 6-12 months and 13-24 months. A comparative analysis of the manifestation and features of the clinical course of the disease was carried out in the subgroups. A comparative assessment of the level of undigested sugars in feces and concentrations of short-chain fatty acids (SCFA) in the dynamics of the disease were carried out. The total level of carbohydrates in feces was determined on the 2^nd, 5^th, 7^th and 10^th day of RVI using the Benedict test. Concentrations of SCFA (acetate, propionate, butyrate) were determined on 2^nd, 5^th and 10^th days by liquid chromatography. As physiological indicators of the total amount of carbohydrates in the feces and fecal concentrations of SCFA, the indicators of 30 relatively healthy children were taken. The "STATISTICA for Windows 13" program was used for statistical processing of the obtained data. Since the quantitative values that were analyzed had a distribution that differed from normal, non-parametric statistical methods were applied.

Results. Children 1-6 months of age with RVI less often had fever and vomiting (p˂0.05), had longer diarrhea (p˂0.05), which was more often accompanied by flatulence, intestinal colic (p˂0.05), than children 13-24 months of age. Children of this subgroup had the highest levels of carbohydrates in feces in the acute period of RVI (р˂0.05 on the 2nd and 5th day relative to children 6-12 months and 13-24 months of age) and in the period of convalescence (р˂0.05 on 10^th day for children 13-24 months of age). In all subgroups of children, reduced concentrations of SCFA were noted in the acute period of RVI (p>0.05 relative to the reference values from the 3^rd to the 5^th day). The most pronounced decrease in the total concentrations of SCFA (p<0.01 relative to the reference values) during the entire period of RVI were observed in children 1-6 months of aged.

Conclusions. RVI is characterized by longer diarrhea which is more often accompanied by flatulence and intestinal colic in children 1-6 months of age, while children 13-24 months of age more often have fever and vomiting. The most pronounced disturbances of carbohydrate metabolism in the intestines and changes in the functional activity of the intestinal microflora during RVI occur in children 1-6 months of age.

The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies.

No conflict of interests was declared by the authors.