CMV reactivation in COVID-19 patients: pouring fuel on the fire
Keywords:cytomegalovirus (CMV), reactivation, COVID-19, lymphopenia, hyperinflammatory response.
Severe SARS-CoV-2 infection could promote CMV reactivation, that further worsens disease prognosis.
This study included admitted patients with recent COVID-19 for one year period in a tertiary hospital, having clinical criteria of CMV reactivation and positive CMV DNAemia.
Fifteen of 559 COVID-19 patients were diagnosed with CMV reactivation (2.7%). 86.6% were male, with a mean age of 63.6 years. Immunodepression was significantly higher in the CMV positive group (p=0.008). Lymphopenia was significantly more important in patients who reactivated CMV (p=<0.001), whereas ferritin level (p=0.019) and IL-6 level (p=0.035) on admission appeared to be significantly lower in this group. There was no significant difference for COVID-19 treatments. ICU admission (p<0 .001) and bacterial infections (p<0.001) appeared to be significant for CMV reactivation. Also, the mortality was significantly higher in the CMV positive group (p=0.042).
This study raises the possible incrimination of lymphopenia, immunosuppression, critical illness, and bacterial infections in CMV reactivation.
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