Can Hematological Parameters be Used for Differential Diagnosis in Rotavirus Infection at any Age of Children? A 6-year Outcomes from a Tertiary Referral Center

Abstract
Aim: Routine blood parameters are widely used to detect of infectious diseases. Our study aimed to investigate the hematological parameters changes in rotavirus (RV) acute gastroenteritis and to evaluate the value of these parameters in children. Methods: In our study, the hematological data of patients diagnosed with RV-positive acute gastroenteritis (RPAGE) and RV-negative acute gastroenteritis (RNAGE) were analyzed between 2015-2020. In addition to the data automatically measured by complete blood count, lymphocyte/monocyte ratio (LMR), neutrophil/lymphocyte ratio (NLR), mean platelet volume/platelet ratio (MPVPR) were calculated. All cases were evaluated in three different age groups (5-year-old). Results: The present study included 2,144 patients (340 children with RPAGE, 1,804 children with RNAGE). Red blood cell count, hemoglobin, and hematocrit were higher in cases over 1 year of age with RPAGE. The MPVPR was lower in all age groups with RPAGE. The cut-off values of MPVPR for predicting Rotavirus infection (RI) were 0.023 (5-year-old group). The LMR was lower and NLR was higher in cases over 1 year of age with RPAGE. The cut-off value of LMR for predicting RI were 1.99 (1-to 5-year-old group) and 0.96 (>5-year-old group). The cut-off value of NLR for predicting RI were 1.41 (1-to 5-year-old group), and 3.79 (>5-year-old group). Conclusion: The low MPVPR can be used as a hematological biomarker for the identification of RPAGE cases in all age groups. Low LMR and high NLR can indicate RPAGE cases in over 1 year of age.