Prevalence and Clinical Manifestation of Astrovirus Gastroenteritis in Adults: A Seven-Year Study in Washington D.C., USA.

Abstract

Gastroenteritis is commonly caused by viral etiologies. The inclusion of astrovirus on multiplex, syndromic gastrointestinal PCR panels allows for the detection and characterization of infected patients. This retrospective, observational, clinical study examines the epidemiology and clinical characteristics of astrovirus infections in adults from our institution in Washington D.C. (USA) over a seven-year period. Chart abstraction was performed to collect patient demographics, laboratory results, clinical presentation, and management. The overall positivity rate of astrovirus was 0.6%. Peak seasons were late winter to spring (February-April). The mean age was 32 years old (range: 18-52 years). All patients presented with gastroenteritis symptoms and were immunocompetent except one. Symptoms varied among diarrhea, abdominal pain, vomiting, and fever, but patients in age group 30-39 years experienced less vomiting (p = 0.01). Infected patients had an increase in monocytes and neutrophils and a decrease in lymphocytes (p < 0.001). Gastrointestinal co-infections were seen in 24% of our patients. In all patients, clinicians acknowledged the detection of astrovirus and discharged patients without further treatment. The median length of stay was 6 h, and no patients were admitted into the intensive care unit. We show that astrovirus infections in immunocompetent adults were associated with mild disease associated with specific cell counts and different symptoms correlated with age.