Okuyan Omer, Elgormus Yusuf, Sayili Ugurcan, Dumur Seyma, Isık Ozlem Erkan, Uzun Hafize
Department of Pediatrics, Medicine Hospital, Istanbul Atlas University, 34408 Istanbul, Turkey.
Clinic of Pediatrics, Medicine Hospital, 34408 Istanbul, Turkey.
Vaccines (Basel). 2023 Mar 2;11(3):580. doi: 10.3390/vaccines11030580.
Rotavirus (RV) is one of the most common and important causes of acute gastroenteritis (AGE) in newborns and children worldwide. The aim of this study was to evaluate the effect of the RV vaccine on the natural history of RV infections using the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and systemic immune inflammatory index (SII) as hematological indexes, clinical findings, and hospitalization.
Children aged 1 month to 5 years who were diagnosed with RV AGE between January 2015 and January 2022 were screened, and 630 patients were included in the study. The SII was calculated by the following formula: neutrophil × platelet/lymphocyte.
Fever and hospitalization were significantly higher and breastfeeding was significantly lower in the RV-unvaccinated group than in the RV-vaccinated group. The NLR, PLR, SII, and CRP were significantly higher in the RV-unvaccinated group ( < 0.05). The NLR, PLR, and SII were significantly higher both in the non-breastfed group than in the breastfed group and in the hospitalized group than in the not hospitalized group ( < 0.05). CRP was not significantly different in either the hospitalization group or the breastfeeding group ( > 0.05). SII and PLR were significantly lower in the RV-vaccinated group than in the RV-unvaccinated group in both the breastfed and non-breastfed subgroups. For NLR and CRP, while there was no significant difference according to RV vaccination status in the breastfed group, there was a significant difference in the non-breastfed group ( value: <0.001; <0.001).
Despite the low level of vaccine coverage, the introduction of RV vaccination had a positive impact on the incidence of RV-positive AGE and related hospitalizations in children. These results showed that breastfed and vaccinated children were less prone to inflammation because their NLR, PLR, and SII ratios were lower. The vaccine does not prevent the disease 100%. However, it can prevent severe disease with exsiccation or death.
轮状病毒（RV）是全球新生儿和儿童急性胃肠炎（AGE）最常见且最重要的病因之一。本研究旨在以中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）及全身免疫炎症指数（SII）作为血液学指标、结合临床症状及住院情况，评估RV疫苗对RV感染自然病程的影响。
筛选2015年1月至2022年1月期间诊断为RV感染所致AGE的1个月至5岁儿童，共纳入630例患者。SII计算公式如下：中性粒细胞×血小板/淋巴细胞。
未接种RV疫苗组的发热及住院率显著高于接种RV疫苗组，母乳喂养率显著低于接种RV疫苗组。未接种RV疫苗组的NLR、PLR、SII及CRP显著更高（P<0.05）。非母乳喂养组的NLR、PLR及SII显著高于母乳喂养组，住院组显著高于未住院组（P<0.05）。住院组和母乳喂养组的CRP均无显著差异（P>0.05）。在母乳喂养和非母乳喂养亚组中，接种RV疫苗组的SII和PLR均显著低于未接种RV疫苗组。对于NLR和CRP，母乳喂养组根据RV疫苗接种状况无显著差异，但非母乳喂养组有显著差异（P值：<0.001；<0.001）。
尽管疫苗接种覆盖率较低，但引入RV疫苗对儿童RV阳性AGE的发病率及相关住院情况产生了积极影响。这些结果表明，母乳喂养且接种疫苗的儿童炎症倾向较低，因为其NLR、PLR和SII比值较低。该疫苗不能100%预防疾病。然而，它可以预防严重脱水或死亡的疾病。
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