Late Breaking Abstract - Cytomegalovirus reactivation in COVID-19 patients with Acute Respiratory Distress Syndrome

Agrawal, Anupam; Garg, Atul; Gurjar, Mohan; Ghoshal, Ujjala; Mishra, Prabhakar; Arya, Akshay; Gutte, Shreyas; Pandey, Gaurav

doi:10.1183/13993003.congress-2021.oa4028

Cited by 3 publications

(5 citation statements)

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“…In our study, COVID-19 patients with CMV infection were associated with longer hospital stay, longer ICU stay, and longer days on MV than those without CMV infection. These findings were consistent with previous studies of CMV infection in critically ill patients 15,16,21–23,35,36 and a recent observational study of critically ill patients with CMV infection. 20 Patients with CMV infection had higher serum levels of CRP, lactate dehydrogenase, lactate, and D-dimer and were more likely to require MV, which may indicate greater disease severity.…”

Section: Discussionsupporting

confidence: 93%

“…17 CMV infections have also been observed in individuals with severe COVID-19. [18][19][20][21][22][23] Several studies have demonstrated a correlation between CMV infection and adverse outcomes in critically ill COVID-19 patients, such as the need for mechanical ventilation (MV) and increased mortality rates. [21][22][23] However, one study indicated that CMV infection did not independently associate with mortality.…”

Section: Introductionmentioning

confidence: 99%

“…[18][19][20][21][22][23] Several studies have demonstrated a correlation between CMV infection and adverse outcomes in critically ill COVID-19 patients, such as the need for mechanical ventilation (MV) and increased mortality rates. [21][22][23] However, one study indicated that CMV infection did not independently associate with mortality. 20 To our knowledge, the association between SARS-CoV-2 shedding and CMV infection remained unknown.…”

Section: Introductionmentioning

confidence: 99%

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Analysis of the effect of cytomegalovirus infection in clinical outcomes and prolonged duration of SARS-CoV-2 shedding in intensive care unit patients with COVID-19 pneumonia

Shen,

Feng,

Sun

et al. 2023

Ther Adv Respir Dis

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Background: Coronavirus disease 2019 (COVID-19) is a global outbreak disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Cytomegalovirus (CMV) infection can occur in critical COVID-19 patients and is associated with adverse clinical outcomes. Objective: The aim of this study was to explore the clinical characteristics and outcome of CMV infection in critical COVID-19 patients. Design: This was a retrospective cohort study. Methods: From May to September 2021, SARS-CoV-2 reverse transcription polymerase chain reaction (RT–PCR)-confirmed COVID-19 patients with intensive care unit (ICU) admission were enrolled. CMV infection was confirmed by PCR. Baseline characteristics, critical illness data and clinical outcomes were recorded and analyzed. Results: Seventy-two RT–PCR-confirmed COVID-19 patients with ICU admission were included during the study period and 48 (66.7%) patients required mechanical ventilation (MV). Overall, in-hospital mortality was 19.4%. Twenty-one (29.2%) patients developed CMV infection. Patients with CMV infection had a higher likelihood of diabetes, higher lactate dehydrogenase and lactate levels, and higher proportions of MV, anticoagulant, and steroid use. Patients with CMV infection were associated with longer duration of SARS-CoV-2 shedding, longer ICU and hospital stay, and fewer ventilator-free days. The independent risk factor for development of CMV infection was a higher accumulative steroid dose. Conclusion: CMV infection adversely impacted the outcomes of critical COVID-19 patients, resulting in longer ICU stays, longer mechanical ventilation uses and prolonged shedding of SARS-CoV-2.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Analysis of the effect of cytomegalovirus infection in clinical outcomes and prolonged duration of SARS-CoV-2 shedding in intensive care unit patients with COVID-19 pneumonia

Shen,

Feng,

Sun

et al. 2023

Ther Adv Respir Dis

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“…As expected, CMV reactivation has been documented in severe COVID-19 (refs. 37,38 ). However, specific sampling of the respiratory tract indicated that latent CMV infection is associated with both increased likelihood of COVID-19 and increased disease severity, even in the absence of virologically confirmed CMV reactivation 39 .…”

Section: Review Articlementioning

confidence: 99%

Comorbidities, multimorbidity and COVID-19

Russell

Lone

Baillie

2023

Nat Med

192

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“…A similar Japanese study on 26 patients admitted to the ICU with severe COVID-19 pneumonia showed that 23% of the patients developed CMV viremia (8). A study conducted in a tertiary care hospital in India showed that CMV reactivation occurred in 38% of the patients admitted to the ICU after COVID-19 ARDS and was associated with 100% mortality (9). Prolonged mechanical ventilation, corticosteroid use, and lymphopenia have been identified as risk factors that lead to CMV reactivation after COVID-19 infection in immunocompetent patients.…”

Section: Discussionmentioning

confidence: 91%

Cytomegalovirus Reactivation in Postrenal Transplant Patients Immediately in Association with Coronavirus Disease 2019 (COVID-19) Infection: A Case Report of 2 Patients and a Brief Review of the Literature

Bale,

Saha,

Shinde

et al. 2023

Nephro-Urol Mon

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Introduction: The coronavirus disease 2019 (COVID-19) infection has been associated with multiple opportunistic infections, including secondary cytomegalovirus (CMV) reactivation. Several cases of CMV syndrome and invasive CMV infection have been reported following severe COVID-19 infection worldwide during the COVID-19 pandemic in both immunocompetent and immunosuppressed patients. A case-control study conducted in India showed that during the first and second waves, CMV was the most common co-infection among fatal cases of severe COVID-19 lung infection in Indian renal transplant recipients. Case Presentation: We present 2 cases of CMV disease in postrenal transplant patients who developed clinical manifestations of CMV co-infection after mild COVID-19 infection during the fourth wave of COVID-19 infection in India. In both cases, CMV infection was treated by discontinuing mycophenolate mofetil and administering ganciclovir injections. However, the treatment resulted in 2 contrasting clinical outcomes: cure and death. Conclusions: We reviewed the recent literature on the increased incidence of CMV reactivation after both COVID-19 infection and vaccination in immunocompetent and immunocompromised populations. Subsequently, we discussed some clinical questions relevant to the population of postrenal transplant recipients after the detection of mild COVID-19 infection.

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Late Breaking Abstract - Cytomegalovirus reactivation in COVID-19 patients with Acute Respiratory Distress Syndrome

Cited by 3 publications

References 0 publications

Analysis of the effect of cytomegalovirus infection in clinical outcomes and prolonged duration of SARS-CoV-2 shedding in intensive care unit patients with COVID-19 pneumonia

Analysis of the effect of cytomegalovirus infection in clinical outcomes and prolonged duration of SARS-CoV-2 shedding in intensive care unit patients with COVID-19 pneumonia

Comorbidities, multimorbidity and COVID-19

Cytomegalovirus Reactivation in Postrenal Transplant Patients Immediately in Association with Coronavirus Disease 2019 (COVID-19) Infection: A Case Report of 2 Patients and a Brief Review of the Literature

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