J Pediatr Infect Dis 2022; 17(03): 137-142
DOI: 10.1055/s-0042-1745836
Original Article

Effect of Rotavirus Infection on Serum Micronutrients and Atopy in Children

1   Division of Pediatric Gastroenterology, Department of Pediatrics, Gaziosmanpaşa Training and Research Hospital, Istanbul, Turkey
2   Department of Pediatrics, Gaziosmanpaşa Training and Research Hospital, Istanbul, Turkey
3   Department of Neuroscience, Bahcesehir University, School of Medicine, Istanbul, Turkey
4   Department of Pharmacology, Bahcesehir University, School of Medicine, Istanbul, Turkey
› Author Affiliations
Funding None.


Objective Rotavirus is a highly infectious and prevalent ribonucleic acid (RNA) virus that causes fatal gastroenteritis in children. Despite vitamin D deficiency is associated with susceptibility to infections, the relationship between ferritin and vitamin B12 levels is not known. This study aimed to investigate and compare the effect of rotavirus on micronutrient levels, atopy, and the frequency of allergic diseases in children with rotavirus.

Methods There were rotavirus gastroenteritis (RVG) (N = 92) and non-rotavirus (control) groups (N = 95). Serum micronutrient levels (B12, ferritin, and 25-hydroxyvitamin D [25-OH-D3]) were checked during the first control after gastroenteritis healed. Patients were also examined for allergic diseases on an average of 17 (14–32) months following rotavirus infection. Serum immunoglobulin E (IgE), eosinophil count, and percentage were analyzed. Skin tests and respiratory function tests were also performed on patients with allergic disease and asthma symptoms.

Results Mean ferritin, B12, and 25-OH-D3 levels were lower in the RVG group compared with the control group. Allergic diseases in the RVG group were more frequent than in the control group. The prevalence of the allergic disease in the RVG group was 16.3%, as opposed to 5.2% in the control group (p = 0.014). The IgE level was significantly higher in the RVG group.

Conclusion Children with rotavirus infection should be followed closely in terms of allergic diseases and micronutrient deficiency. Furthermore, rotavirus infection should be prevented in the society and early treatment should be made available via tests detecting micronutrient deficiency.

Authors' Contributions

M.K.B., C.D., and F.O. contributed to the conception and design of this study. M.K.B. and C.D. collected the data. A.S. and F.O. contributed to analysis and interpretation of data. M.K.B., A.S., and F.O. performed the statistical analysis and drafted the manuscript and figures. M.K.B., A.S., C.D., and F.O. critically reviewed the manuscript and supervised the whole study process. All authors read and approved the final manuscript. All authors agree to be accountable for all aspects of work ensuring integrity and accuracy.

Publication History

Received: 09 December 2021

Accepted: 25 February 2022

Article published online:
17 May 2022

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  • References

  • 1 Parashar UD, Bresee JS, Gentsch JR, Glass RI. Rotavirus. Emerg Infect Dis 1998; 4 (04) 561-570
  • 2 Crawford SE, Ramani S, Tate JE. et al. Rotavirus infection. Nat Rev Dis Primers 2017; 3: 17083
  • 3 Yuan L, Honma S, Kim I, Kapikian AZ, Hoshino Y. Resistance to rotavirus infection in adult volunteers challenged with a virulent G1P1A[8] virus correlated with serum immunoglobulin G antibodies to homotypic viral proteins 7 and 4. J Infect Dis 2009; 200 (09) 1443-1451
  • 4 Tate JE, Burton AH, Boschi-Pinto C, Parashar UD. World Health Organization -Coordinated Global Rotavirus Surveillance Network. Global, Regional, and National Estimates of Rotavirus Mortality in Children <5 Years of Age, 2000-2013. Clin Infect Dis 2016; 62 (02) 96-105
  • 5 Lin C-L, Chen S-C, Liu S-Y, Chen K-T. Disease caused by rotavirus infection. Open Virol J 2014; 8: 14-19
  • 6 Osborne MP, Haddon SJ, Worton KJ. et al. Rotavirus-induced changes in the microcirculation of intestinal villi of neonatal mice in relation to the induction and persistence of diarrhea. J Pediatr Gastroenterol Nutr 1991; 12 (01) 111-120
  • 7 Estes MK, Kang G, Zeng CQ, Crawford SE, Ciarlet M. Pathogenesis of rotavirus gastroenteritis. Novartis Found Symp 2001; 238: 82-96 , discussion 96–100
  • 8 Gombart AF. The vitamin D-antimicrobial peptide pathway and its role in protection against infection. Future Microbiol 2009; 4 (09) 1151-1165
  • 9 Tian G, Liang X, Chen D. et al. Vitamin D3 supplementation alleviates rotavirus infection in pigs and IPEC-J2 cells via regulating the autophagy signaling pathway. J Steroid Biochem Mol Biol 2016; 163: 157-163
  • 10 Bucak IH, Ozturk AB, Almis H. et al. Is there a relationship between low vitamin D and rotaviral diarrhea?. Pediatr Int (Roma) 2016; 58 (04) 270-273
  • 11 Reimerink J, Stelma F, Rockx B. et al. Early-life rotavirus and norovirus infections in relation to development of atopic manifestation in infants. Clin Exp Allergy 2009; 39 (02) 254-260
  • 12 Cheung DS, Grayson MH. Role of viruses in the development of atopic disease in pediatric patients. Curr Allergy Asthma Rep 2012; 12 (06) 613-620
  • 13 Kovalszki A, Weller PF. Eosinophilia. Prim Care 2016; 43 (04) 607-617
  • 14 Okonji OC, Okonji EF, Mohanan P. et al. Marburg virus disease outbreak amidst COVID-19 in the Republic of Guinea: a point of contention for the fragile health system?. Clin Epidemiol Glob Health 2022; 13: 100920
  • 15 Asad Khan FM, Islam Z, Kazmi SK. et al. The concomitant viral epidemics of Rift Valley fever and COVID-19: a lethal combination for Kenya. Trop Doct 2022; 52 (01) 6-8
  • 16 Ismail Z, Aborode AT, Oyeyemi AA. et al. Impact of COVID-19 pandemic on viral hepatitis in Africa: challenges and way forward. Int J Health Plann Manage 2022; 37 (01) 547-552
  • 17 Behera DK, Mishra S. The burden of diarrhea, etiologies, and risk factors in India from 1990 to 2019: evidence from the global burden of disease study. BMC Public Health 2022; 22 (01) 92
  • 18 Nouri-Vaskeh M, Sadeghifard S, Saleh P, Farhadi J, Amraii M, Ansarin K. Vitamin D deficiency among patients with tuberculosis: a cross-sectional study in Iranian-Azari population. Tanaffos 2019; 18 (01) 11-17
  • 19 Walker VP, Modlin RL. The vitamin D connection to pediatric infections and immune function. Pediatr Res 2009; 65 (5 Pt 2): 106R-113R
  • 20 Mousa A, Naderpoor N, Teede HJ, De Courten MP, Scragg R, De Courten B. Vitamin D and cardiometabolic risk factors and diseases. Minerva Endocrinol 2015; 40 (03) 213-230
  • 21 Di Rosa M, Malaguarnera M, Nicoletti F, Malaguarnera L. Vitamin D3: a helpful immuno-modulator. Immunology 2011; 134 (02) 123-139
  • 22 Yamshchikov AV, Desai NS, Blumberg HM, Ziegler TR, Tangpricha V. Vitamin D for treatment and prevention of infectious diseases: a systematic review of randomized controlled trials. Endocr Pract 2009; 15 (05) 438-449
  • 23 Thornton KA, Marín C, Mora-Plazas M, Villamor E. Vitamin D deficiency associated with increased incidence of gastrointestinal and ear infections in school-age children. Pediatr Infect Dis J 2013; 32 (06) 585-593
  • 24 Burris D, Rosenberg CE, Schwartz JT. et al. Pediatric hypereosinophilia: characteristics, clinical manifestations, and diagnoses. J Allergy Clin Immunol Pract 2019; 7 (08) 2750-2758.e2