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Outcomes of Cytomegalovirus Viremia Treatment in Critically Ill Patients With COVID-19 Infection.
Schoninger, Scott; Dubrovskaya, Yanina; Marsh, Kassandra; Altshuler, Diana; Prasad, Prithiv; Louie, Eddie; Weisenberg, Scott; Hochman, Sarah; Fridman, David; Trachuk, Polina.
  • Schoninger S; Division of Internal Medicine, Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA.
  • Dubrovskaya Y; Department of Pharmacy, NYU Langone Health, New York, New York, USA.
  • Marsh K; Department of Pharmacy, NYU Langone Health, New York, New York, USA.
  • Altshuler D; Department of Pharmacy, NYU Langone Health, New York, New York, USA.
  • Prasad P; Division of Infectious Diseases and Immunology, Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA.
  • Louie E; Division of Infectious Diseases and Immunology, Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA.
  • Weisenberg S; Division of Infectious Diseases and Immunology, Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA.
  • Hochman S; Division of Infectious Diseases and Immunology, Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA.
  • Fridman D; Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA.
  • Trachuk P; Division of Infectious Diseases and Immunology, Department of Medicine, New York University Grossman School of Medicine, New York, New York, USA.
Open Forum Infect Dis ; 9(7): ofac286, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1895832
ABSTRACT

Background:

Patients with coronavirus disease 2019 (COVID-19) admitted to the intensive care unit (ICU) have poor outcomes and frequently develop comorbid conditions, including cytomegalovirus (CMV) reactivation. The implications of CMV reactivation in this setting are unknown. We aimed to investigate if treatment of CMV viremia improved in-hospital mortality in ICU patients with COVID-19.

Methods:

In this single-center retrospective study, we analyzed clinical outcomes in patients diagnosed with COVID-19 pneumonia and CMV viremia admitted to an ICU from March 1, 2020, to April 30, 2021, who either received treatment (ganciclovir and/or valganciclovir) or received no treatment. The primary outcome was all-cause in-hospital mortality. Secondary outcomes were total hospital length of stay (LOS), ICU LOS, requirement for extracorporeal membrane oxygenation (ECMO) support, duration of mechanical ventilation (MV), and predictors of in-hospital mortality.

Results:

A total of 80 patients were included, 43 patients in the treatment group and 37 in the control group. Baseline characteristics were similar in both groups. CMV-treated patients were more likely to test positive for CMV earlier in their course, more likely to be on ECMO, and received higher total steroid doses on average. In-hospital mortality was similar between the 2 groups (37.2% vs 43.2.0%; P = .749). There was no significant difference in hospital LOS, though CMV-treated patients had a longer ICU LOS.

Conclusions:

Treatment of CMV viremia did not decrease in-hospital mortality in ICU patients with COVID-19, but the sample size was limited. CMV viremia was significantly associated with total steroid dose received and longer ICU stay.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Language: English Journal: Open Forum Infect Dis Year: 2022 Document Type: Article Affiliation country: Ofid

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Language: English Journal: Open Forum Infect Dis Year: 2022 Document Type: Article Affiliation country: Ofid