CMV Infection Following mRNA SARS-CoV-2 Vaccination in Solid Organ Transplant Recipients

Chakravorty, Shourjo; Cochrane, A.; Psotka, Mitchell A.; Shrestha, Anuj; Marinak, L.M.; Thatcher, Amy; Shlobin, Oksana A.; Brown, Alison; King, Christopher S.; Ahmad, Kareem; Khangoora, Vikramjit; Singhal, Anju; Nathan, Steven D.; Aryal, Shambhu

doi:10.1097/txd.0000000000001344

Cited by 4 publications

(3 citation statements)

References 20 publications

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“…Aunado al uso de corticoesteroides y algunas comorbilidades se ha descrito que es posible que la vacunación contra la COVID-19 provoque una desregulación inmunitaria en algunos receptores de trasplantes de órganos sólidos, lo que aumenta los riesgos de reactivación del CMV (95) . Un estudio reporto 10 casos de infección por CMV en receptores de trasplantes de órganos sólidos poco después de la vacunación con ARNm de COVID-19, por lo cual es otro importante factor que debe tomarse en consideración (96) .…”

Section: Resultados Coinfección Sars-cov-2 /Cmv /Veb Y Reactivación V...unclassified

Reactivación y coinfecciones virales en COVID-19: otro elemento a considerar. Revisión Sistemática

Ponce-Pincay,

Diana

2023

Kasmera

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La COVID-19 es una enfermedad que afecta a la población mundial, representando un reto social y sanitario. El SARS-CoV-2 muestra afinidad por el sistema respiratorio, por ser la puerta de entrada y el sitio primario de replicación. Aunque las manifestaciones respiratorias sean las más frecuentes, se han reportado manifestaciones gastrointestinales, renales, neurológicas, cardiacas; entre otras. Un elemento que no ha recibido en la atención que merece es la reactivación y las coinfecciones virales. Como es bien sabido, el tratamiento de COVID-19 en sus formas graves y críticas incluyen productos biológicos, corticoesteroides, ventilación mecánica y la múltiple farmacoterapia, aunado a la fisiopatología propia de la enfermedad que es caracterizada por una tormenta de citoquinas; conlleva a que se reactiven infecciones virales que se consideran latentes y crónicas, agravando aún más el cuadro clínico. En esta revisión sistemática se ha encontrado que eventos hematológicos como la leucopenia y linfopenia junto al uso desmedido de esteroides, y la larga estancia hospitalaria puede conllevar a la reactivación de virus que pertenecen a la familia Herperviridae (Virus Epstein-Barr (VEB), Citomegalovirus (CMV) y el virus del Herpes (VHS1/2)) así como virus hepatotropos (virus de la Hepatitis B (VHB) y C(VHC), que pueden complicar el pronóstico clínico

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Section: Resultados Coinfección Sars-cov-2 /Cmv /Veb Y Reactivación V...unclassified

Reactivación y coinfecciones virales en COVID-19: otro elemento a considerar. Revisión Sistemática

Ponce-Pincay,

Diana

2023

Kasmera

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“…94 CMV DNAemia may occur more frequently in SOT recipients who received COVID-19 messenger RNA (mRNA) vaccination. 95 The mechanism for this is unclear, although the authors positimmune senescence or dysregulation as a possible cause.…”

Section: Management Of CMV Infectionmentioning

confidence: 99%

What’s New: Updates on Cytomegalovirus in Solid Organ Transplantation

Stewart,

Kotton

2023

Transplantation

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Cytomegalovirus (CMV) is one of the most common infections occurring after solid organ transplantation. This high burden of disease, which incurs sizeable morbidity, may be worsening with the proportion of high-risk D+/R− solid organ transplantation recipients increasing in some regions globally. Cohort studies continue to support either universal prophylaxis or preemptive therapy as effective prevention strategies. Letermovir prophylaxis was noninferior to valganciclovir in adult high-risk D+/R− kidney transplant recipients with fewer drug-related adverse events in a recent clinical trial and has now been approved for such use in some regions. Maribavir preemptive therapy failed to demonstrate noninferiority when compared with valganciclovir in hematopoietic stem cell transplant recipients but looked promising for safety. Donor matching could be useful in prevention CMV disease with a survival advantage demonstrated in seronegative recipients waiting up to 30 mo for a seronegative kidney. Immune-guided prophylaxis resulted in fewer CMV infection episodes in lung transplant recipients when compared with fixed-duration prophylaxis in a recent clinical trial. For treatment of refractory or resistant CMV infection, maribavir was more efficacious and better tolerated when compared with investigator-initiated therapy in its registration trial for this condition. Further research regarding best treatment and prophylaxis of resistant or refractory CMV infection is needed to reflect best clinical practice choices. Optimal use of immune globulin or CMV-specific T cells for prevention or treatment of CMV disease remains undefined. Standardized definitions for the design of CMV clinical trials have been developed. In this review, we highlight recent updates in the field from data published since 2018.

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“…Apart from VZV and HSV reactivations we also had a case of anterior CMV uveitis in our study. So far there is only one other published case of an ocular CMV reactivation after COVID-19 immunization with a vaccine (15), but several extraocular CMV infections after COVID-vaccines were reported (30)(31)(32).…”

Section: Casementioning

confidence: 99%

Herpetic anterior uveitis following COVID-19 vaccines: a case series

Ott,

Nagamany,

Zandi

et al. 2023

Front. Med.

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PurposeTo report a case series of herpetic uveitis following COVID-19 vaccinations.MethodsDemographic, clinical and treatment-related data of herpetic anterior uveitis cases was collected at five tertiary eye hospitals between January 2021 and June 2022. A retrospective database review at one of the centers comparing the number of cases of herpetic eye disease before and after the introduction of COVID-19 vaccination was performed as well.ResultsTwenty-four patients (9 female, 15 male) with a mean age of 54 years (range 28–83 years) were diagnosed with herpetic uveitis, reporting an onset of symptoms 3–42 days after the first, second or third dose of COVID-19 vaccination. Median time between vaccination and onset of herpetic eye disease was 10 days (mean 12.7 ± 10.15 days) days. The administered vaccines were BNT162b2, mRNA-1273, BBIBP-CorV and Ad26.COV2.S. The cases included 11 HSV, 10 VZV and 1 CMV anterior uveitis, 2 were not further specified. There was an equal number of first episodes (n = 12, 50%) and recurrent episodes (n = 12, 50%). Response to established regimens was generally good. The retrospective database review revealed the exact same incidence of herpetic uveitis during the pandemic and ongoing vaccination compared to prior SARS-CoV-2.ConclusionThis report includes 24 cases of herpetic anterior uveitis in a temporal relationship to various COVID-19 vaccines. This study supports the potential risk of herpetic eye disease following COVID-19 vaccines, but proof of a direct, causal relationship is missing.

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CMV Infection Following mRNA SARS-CoV-2 Vaccination in Solid Organ Transplant Recipients

Cited by 4 publications

References 20 publications

Reactivación y coinfecciones virales en COVID-19: otro elemento a considerar. Revisión Sistemática

Reactivación y coinfecciones virales en COVID-19: otro elemento a considerar. Revisión Sistemática

What’s New: Updates on Cytomegalovirus in Solid Organ Transplantation

Herpetic anterior uveitis following COVID-19 vaccines: a case series

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