Your browser doesn't support javascript.
Cytomegalovirus blood reactivation in COVID-19 critically ill patients: risk factors and impact on mortality.
Gatto, Ilenia; Biagioni, Emanuela; Coloretti, Irene; Farinelli, Carlotta; Avoni, Camilla; Caciagli, Valeria; Busani, Stefano; Sarti, Mario; Pecorari, Monica; Gennari, William; Guaraldi, Giovanni; Franceschini, Erica; Meschiari, Marianna; Mussini, Cristina; Tonelli, Roberto; Clini, Enrico; Cossarizza, Andrea; Girardis, Massimo.
  • Gatto I; Anesthesia and Intensive Care Medicine, Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy.
  • Biagioni E; Anesthesia and Intensive Care Medicine, Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy.
  • Coloretti I; Anesthesia and Intensive Care Medicine, Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy.
  • Farinelli C; Anesthesia and Intensive Care Medicine, Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy.
  • Avoni C; Anesthesia and Intensive Care Medicine, Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy.
  • Caciagli V; Anesthesia and Intensive Care Medicine, Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy.
  • Busani S; Anesthesia and Intensive Care Medicine, Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy.
  • Sarti M; Microbiology and Virology Unit, Azienda Ospedaliero-Universitaria Policlinico, 41124, Modena, Italy.
  • Pecorari M; Microbiology and Virology Unit, Azienda Ospedaliero-Universitaria Policlinico, 41124, Modena, Italy.
  • Gennari W; Virology and Molecular Microbiology Unit, Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy.
  • Guaraldi G; Infectious Diseases Unit, Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy.
  • Franceschini E; Infectious Diseases Unit, Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy.
  • Meschiari M; Infectious Diseases Unit, Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy.
  • Mussini C; Infectious Diseases Unit, Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy.
  • Tonelli R; Respiratory Diseases Unit, Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy.
  • Clini E; Respiratory Diseases Unit, Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy.
  • Cossarizza A; Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena, Italy.
  • Girardis M; Anesthesia and Intensive Care Medicine, Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy. girardis.massimo@unimo.it.
Intensive Care Med ; 48(6): 706-713, 2022 06.
Article in English | MEDLINE | ID: covidwho-1899124
ABSTRACT

PURPOSE:

Cytomegalovirus (CMV) reactivation in immunocompetent critically ill patients is common and relates to a worsening outcome. In this large observational study, we evaluated the incidence and the risk factors associated with CMV reactivation and its effects on mortality in a large cohort of patients affected by coronavirus disease 2019 (COVID-19) admitted to the intensive care unit (ICU).

METHODS:

Consecutive patients with confirmed SARS-CoV-2 infection and acute respiratory distress syndrome admitted to three ICUs from February 2020 to July 2021 were included. The patients were screened at ICU admission and once or twice per week for quantitative CMV-DNAemia in the blood. The risk factors associated with CMV blood reactivation and its association with mortality were estimated by adjusted Cox proportional hazards regression models.

RESULTS:

CMV blood reactivation was observed in 88 patients (20.4%) of the 431 patients studied. Simplified Acute Physiology Score (SAPS) II score (HR 1031, 95% CI 1010-1053, p = 0.006), platelet count (HR 0.0996, 95% CI 0.993-0.999, p = 0.004), invasive mechanical ventilation (HR 2611, 95% CI 1223-5571, p = 0.013) and secondary bacterial infection (HR 5041; 95% CI 2852-8911, p < 0.0001) during ICU stay were related to CMV reactivation. Hospital mortality was higher in patients with (67.0%) than in patients without (24.5%) CMV reactivation but the adjusted analysis did not confirm this association (HR 1141, 95% CI 0.757-1721, p = 0.528).

CONCLUSION:

The severity of illness and the occurrence of secondary bacterial infections were associated with an increased risk of CMV blood reactivation, which, however, does not seem to influence the outcome of COVID-19 ICU patients independently.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Cytomegalovirus Infections / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Humans Language: English Journal: Intensive Care Med Year: 2022 Document Type: Article Affiliation country: S00134-022-06716-y

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Main subject: Cytomegalovirus Infections / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Humans Language: English Journal: Intensive Care Med Year: 2022 Document Type: Article Affiliation country: S00134-022-06716-y