Prevalence of six gastrointestinal viruses among Lebanese patients with gastroenteritis

Abstract

Introduction: Acute viral gastroenteritis is caused by several viruses including adenovirus, astrovirus, norovirus, rotavirus, sapovirus, and coronavirus. In Lebanon, no study has been conducted yet on the presence of a panel of gastrointestinal viruses in individuals with gastroenteritis. Also, concrete data on the epidemiology of gastrointestinal viruses does not exist since laboratories rely on conventional methods of diagnosis. Moreover, in the current COVID-19 pandemic, studies have shown that coronavirus can be detected in the stools of patients presenting with diarrhea. However, no such study has been conducted in Lebanon. Methodology: 271 stool samples were collected from the laboratory medicine department of Lebanese hospitals and medical centers during a period of 1 year. Multiplex qPCR kits, Allplex GI- Virus Assay and Maccura’s SARS-CoV-2 Fluorescent PCR, were used to diagnose six gastrointestinal viruses which are adenovirus, astrovirus, norovirus, rotavirus, sapovirus, and the SARS-CoV-2 strain of coronavirus. Results: Gastrointestinal viruses were detected in 21% of the 271 samples (n=57). The most prevalent virus was rotavirus (7.7%, n=21), followed by SARS-CoV-2 (5.2%, n=14), norovirus GII (3.3%, n=9), astrovirus (2.6%, n=7), norovirus GI (1.5%, n=4), and sapovirus (0.7%, n=2). Adenovirus was not detected. Infants were mostly infected. Viruses were observed during all the seasons, with a higher prevalence in summer and fall. All the samples positive for a single virus belonged to outpatients, except for samples positive for SARSCoV- 2 and rotavirus as single infections. Conclusion: The use of multiplex qPCR assays in the diagnosis of gastrointestinal viruses has identified gaps and improved the rates of detection of viruses. The results can help health professionals take preventive infection control measures against the viruses, particularly in hospitals.