Evaluation of Hemoglobin, Albumin, Lymphocyte, and Platelet Score, Neutrophil-to-Lymphocyte Ratio, and Platelet-to-Lymphocyte Ratio in Pediatric Patients with Rotavirus Enteritis

Objective: Rotavirus enteritis (RV-e) continues to play a major role in hospitalization and morbidity in patients with acute gastroenteritis (AGE). Identifying new biomarkers that can improve risk assessment of RV-e is crucial for effective disease management. This study aimed to evaluate systemic immune/inflammatory index (SII) markers and hemoglobin, albumin, lymphocyte, and platelet score (HALP score) in children with RV-e. Materials and Methods: This retrospective cohort study was conducted in the pediatric emergency outpatient clinic (PEOC) of a tertiary-level training and research hospital, involving 816 patients. The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and HALP score were used to evaluate inflammation in cases of rotavirus (RV) and other types of enteritis. Results: A total of 816 patients were included in the study, of whom 45.3% were female and 54.7% were male. The hospitalization rate due to RV-e was higher than that of non- RV-e cases, with 47.5% (n=85) of RV-e patients being hospitalized (p<0.001). Both NLR and PLR was elevated in hospitalized patients within the RV-e group (p<0.001 for both). Hospitalization was found to be 1.45 times more likely (95% confidence interval [CI]: 1.09- 1.94) among patients with low HALP scores, six times more likely (95% CI: 3.52-10.26) in patients with RV-e, and 2.88 times more likely (95% CI: 1.40-5.88) in children under five years of age. Conclusion: This study demonstrated that the frequency of hospitalization increased in patients with low HALP scores. We think that the HALP score may serve as a simple and rapid marker to aid clinicians in early treatment planning, especially for patients diagnosed with RV-e in emergency settings.