REACTIVATION OF EPSTEIN-BARR VIRUS AND CYTOMEGALOVIRUS INFECTION IN PATIENTS WITH COVID-19

ABSTRACT

SESSION TITLE Studies on COVID-19 Infections Posters SESSION TYPE Original Investigation Posters PRESENTED ON 10/18/2022 0130 pm - 0230 pm PURPOSE: Latent Epstein-Barr virus (EBV) and cytomegalovirus (CMV) are commonly reactivated in critically ill patients with severe infections. This study aimed to evaluate the proportion of reactivation of EBV and CMV and its impact on length of stay, need for ventilation, and Ichikado CT scores in patients with coronavirus disease 2019 (COVID-19). METHODS: A retrospective study was conducted comprising adult patients admitted to our hospital with COVID-19 infection from June 2021 to September 2021. Patients were divided into groups virus-free, EBV-only, CMV-only, and EBV and CMV detected. Primary outcomes were length of stay, need for ventilation, and Ichikado CT score. Descriptive statistics, one-way ANOVA, Games-Howell, and Kruskal-Wallis tests were used. RESULTS: 189 patients were included with a median age of 51 years [41 – 66], 80 (42.3%) were female and 109 (57.7%) were male. CD4(+) counts were lower in all viral reactivation groups. EBV-only (157 cell/µl [93 – 279.2] ), CMV-only (82.5 cell/µl [65.5 – 323.7] ), both viruses (62.5 cell/µl [47.5 – 135.5]) and virus-free (221 cell/µl [117 – 318]), (H(3) = 12.029, p = < 0.01). A significant increase in the Ichikado CT score was seen in the viral reactivation groups. EBV 186.5 [43.6], CMV 177.5 [41.6], both-viruses group 204 [50.3] vs. virus-free 161 [45.8],( H(3) = 15.770, p = < 0.01). There was an increase in days of hospitalization when comparing the virus-free and the viral reactivation groups. EBV (9 days [5.5-15.5]), CMV (17 days [3-33]), both viruses (23 days [8-31]) vs. virus-free (5 days [3.5-9]), (H(3) = 15.487, p = < 0.01). Regarding the need for assisted ventilation, there was no difference between groups. 7 (9.1%) patients in the virus-free group, 29 (29.9%) patients in the EBV group, 2 (33.3%) patients in the CMV group, and 2 (22.2%) patients in the both-viruses group needed mechanical ventilation (X2 (3, N=189) = 11.699, p= 0.08). Additionally, a statistically significant decrease in albumin levels on admission was found in the EBV-only patients compared to the virus-free group, (3.4 g/dL [0.44] vs 3.75 g/dL [0.46], F(3,185) = 5.483, p = < 0.01). CONCLUSIONS: Viral reactivation is associated with lower CD4(+) count, an increase in length of stay, and higher Ichikado CT scores. CLINICAL IMPLICATIONS EVB and CMV reactivation is associated with low CD4(+) counts and longer hospital stay. DISCLOSURES No relevant relationships by David Akinwale No relevant relationships by Angelica Almaguer No relevant relationships by Sushen Bhalla No relevant relationships by Ailine Canete Cruz No relevant relationships by Ndiya Emeaba Speaker/Speaker's relationship with johnson and johnson Please note approx year 2000 Added 03/31/2022 by Joseph Gathe, value=Honoraria clinical research relationship with gilead Please note since 1990 Added 03/31/2022 by Joseph Gathe, value=Grant/Research clinical research relationship with ansun Please note 2020 Added 03/31/2022 by Joseph Gathe, value=Grant/Research Support clinical research relationship with regeneron Please note 2020 Added 03/31/2022 by Joseph Gathe, value=Grant/Research Support No relevant relationships by Jesus Salvador Gonzalez Lopez No relevant relationships by Najia Hussaini No relevant relationships by Claudia Ramirez No relevant relationships by Salim Surani No relevant relationships by Daryelle Varon No relevant relationships by Joseph Varon No relevant relationships by Mohamed Ziad