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 rotavirus-related 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.

Keywords:

• Rotavirus
• systemic disease
• complication
• clinical manifestation
• pathogenesis

Acknowledgments

The authors thank freepik and edraw for their assistance with regard to graphic illustrations.

Disclosure statement

The authors declare that they have no conflict of interest.

Author contributions

Q.P. and Z.M. designed and directed the project; Z.D. wrote the manuscript with support from M.P., Y.S., G.Z. and Y.X.; X.F. and X.Y. searched and reviewed the literatures, and they aided in interpreting the results. Z.D., Y.S., X.F. and X.Y. assessed the screened literatures; Z.M. designed the figures; G.Z. and Y.X. drew the figures; Q.P. and M.P. directed the revision of the manuscript; all authors provided critical feedback and contributed to the final version of the manuscript.

Additional information

Funding

This work was supported by the following: the National Natural Science Foundation of China [81960606 to Z.D.]; Yunnan Fundamental Research Projects [grant no. 2017FE468(-124) to Z.D.]; the China Scholarship Council for funding PhD fellowships [201708530234 to Z.M.].