tetano
Editor, Senior Moderator
Ther Adv Respir Dis
. 2023 Jan-Dec:17:17534666231209150.
doi: 10.1177/17534666231209150. 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
Hsiao-Chin Shen[SUP] 1 2 [/SUP], Jia-Yih Feng[SUP] 1 3 [/SUP], Chuan-Yen Sun[SUP] 1 [/SUP], Jhong-Ru Huang[SUP] 1 [/SUP], Yuh-Min Chen[SUP] 1 3 [/SUP], Wei-Chih Chen[SUP] 1 3 4 [/SUP], Kuang-Yao Yang[SUP] 5 [/SUP]
Affiliations
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.
Keywords: COVID-19; SARS-CoV-2; cytomegalovirus infection; steroids; virus shedding.
. 2023 Jan-Dec:17:17534666231209150.
doi: 10.1177/17534666231209150. 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
Hsiao-Chin Shen[SUP] 1 2 [/SUP], Jia-Yih Feng[SUP] 1 3 [/SUP], Chuan-Yen Sun[SUP] 1 [/SUP], Jhong-Ru Huang[SUP] 1 [/SUP], Yuh-Min Chen[SUP] 1 3 [/SUP], Wei-Chih Chen[SUP] 1 3 4 [/SUP], Kuang-Yao Yang[SUP] 5 [/SUP]
Affiliations
- PMID: 37949827
- PMCID: PMC10640799
- DOI: 10.1177/17534666231209150
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.
Keywords: COVID-19; SARS-CoV-2; cytomegalovirus infection; steroids; virus shedding.