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Article ; Online: Cytomegalovirus infection in critically ill patients with COVID-19.

Niitsu, Takayuki / Shiroyama, Takayuki / Hirata, Haruhiko / Noda, Yoshimi / Adachi, Yuichi / Enomoto, Takatoshi / Hara, Reina / Amiya, Saori / Uchiyama, Akinori / Takeda, Yoshito / Kumanogoh, Atsushi

The Journal of infection

2021 Volume 83, Issue 4, Page(s) 496–522

MeSH term(s)	COVID-19 ; Critical Illness ; Cytomegalovirus ; Cytomegalovirus Infections ; Humans ; SARS-CoV-2
Language	English
Publishing date	2021-07-09
Publishing country	England
Document type	Letter ; Research Support, Non-U.S. Gov't
ZDB-ID	424417-5
ISSN	1532-2742 ; 0163-4453
ISSN (online)	1532-2742
ISSN	0163-4453
DOI	10.1016/j.jinf.2021.07.004
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Zs.A 1501: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article: 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

Open forum infectious diseases

2022 Volume 9, Issue 7, Page(s) ofac286

Abstract: Background: Patients with coronavirus disease 2019 (COVID-19) admitted to the intensive care unit ... 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 ...

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%; 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.
Language	English
Publishing date	2022-06-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	2757767-3
ISSN	2328-8957
ISSN	2328-8957
DOI	10.1093/ofid/ofac286
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Article ; Online: COVID-19 and Cytomegalovirus Co-infection: A Challenging Case of a Critically Ill Patient with Gastrointestinal Symptoms.

Amaral, Pedro Hf / Ferreira, Bernadete Mc / Roll, Sergio / Neves, Precil Dmm / Pivetta, Luca Ga / Mohrbacher, Sara / Dias, Eduardo Rm / Sato, Victor Ah / Oliveira, Érico S / Pereira, Leonardo Vb / Bales, Alessandra M / Nardotto, Luciana L / Ferreira, Jéssica N / Cuvello-Neto, Américo L / Chocair, Pedro R

European journal of case reports in internal medicine

2020 Volume 7, Issue 10, Page(s) 1911

Abstract: ... we describe the first case of COVID-19 and cytomegalovirus (CMV) co-infection in a critically ill patient ... in a critically ill patient.: Learning points: We describe a case of COVID-19 and cytomegalovirus (CMV ... co-infection in a critically ill patient.Clinical symptoms simulated mesenteric vascular involvement and ...

Abstract	COVID-19 is a severe disease that has reached pandemic status. To the best of our knowledge, we describe the first case of COVID-19 and cytomegalovirus (CMV) co-infection in a critically ill patient. We discuss the challenge of establishing the diagnosis as well as the management of tissue-invasive gastrointestinal CMV infection (TI-GI CMV) simulating vascular involvement and intestinal obstruction in a critically ill patient. Learning points: We describe a case of COVID-19 and cytomegalovirus (CMV) co-infection in a critically ill patient.Clinical symptoms simulated mesenteric vascular involvement and intestinal obstruction.The successful management of invasive CMV colitis in a patient with COVID-19 with atypical symptoms is described.
Keywords	covid19
Language	English
Publishing date	2020-09-02
Publishing country	Italy
Document type	Journal Article
ISSN	2284-2594
ISSN (online)	2284-2594
DOI	10.12890/2020_001911
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Article: COVID-19 and Cytomegalovirus Co-infection: A Challenging Case of a Critically Ill Patient with Gastrointestinal Symptoms

Eur J Case Rep Intern Med

Abstract: ... in a critically ill patient. LEARNING POINTS: We describe a case of COVID-19 and cytomegalovirus (CMV) co-infection ... we describe the first case of COVID-19 and cytomegalovirus (CMV) co-infection in a critically ill patient ... in a critically ill patient.Clinical symptoms simulated mesenteric vascular involvement and intestinal obstruction ...

Abstract	COVID-19 is a severe disease that has reached pandemic status. To the best of our knowledge, we describe the first case of COVID-19 and cytomegalovirus (CMV) co-infection in a critically ill patient. We discuss the challenge of establishing the diagnosis as well as the management of tissue-invasive gastrointestinal CMV infection (TI-GI CMV) simulating vascular involvement and intestinal obstruction in a critically ill patient. LEARNING POINTS: We describe a case of COVID-19 and cytomegalovirus (CMV) co-infection in a critically ill patient.Clinical symptoms simulated mesenteric vascular involvement and intestinal obstruction.The successful management of invasive CMV colitis in a patient with COVID-19 with atypical symptoms is described.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #884061
Database	COVID19

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Article ; Online: Prevalence and risk factors of cytomegalovirus reactivation in critically Ill patients with COVID-19 pneumonia.

Tassaneeyasin, Tanapat / Sungkanuparph, Somnuek / Srichatrapimuk, Sirawat / Charoensri, Attawit / Thammavaranucupt, Kanin / Jayanama, Kulapong / Kirdlarp, Suppachok

PloS one

2024 Volume 19, Issue 5, Page(s) e0303995

Abstract: Backgrounds: In critically ill patients with COVID-19, secondary infections are potentially life ... risk factors of CMV reactivation among critically ill immunocompetent patients with COVID-19 pneumonia ... with developing CMV reactivation.: Conclusion: In critically ill COVID-19 patients, CMV reactivation is ...

Abstract	Backgrounds: In critically ill patients with COVID-19, secondary infections are potentially life-threatening complications. This study aimed to determine the prevalence, clinical characteristics, and risk factors of CMV reactivation among critically ill immunocompetent patients with COVID-19 pneumonia. Methods: A retrospective cohort study was conducted among adult patients who were admitted to ICU and screened for quantitative real-time PCR for CMV viral load in a tertiary-care hospital during the third wave of the COVID-19 outbreak in Thailand. Cox regression models were used to identify significant risk factors for developing CMV reactivation. Results: A total of 185 patients were studied; 133 patients (71.9%) in the non-CMV group and 52 patients (28.1%) in the CMV group. Of all, the mean age was 64.7±13.3 years and 101 patients (54.6%) were males. The CMV group had received a significantly higher median cumulative dose of corticosteroids than the non-CMV group (301 vs 177 mg of dexamethasone, p<0.001). Other modalities of treatments for COVID-19 including anti-viral drugs, anti-cytokine drugs and hemoperfusion were not different between the two groups (p>0.05). The 90-day mortality rate for all patients was 29.1%, with a significant difference between the CMV group and the non-CMV group (42.3% vs. 24.1%, p = 0.014). Median length of stay was longer in the CMV group than non-CMV group (43 vs 24 days, p<0.001). The CMV group has detectable CMV DNA load with a median [IQR] of 4,977 [1,365-14,742] IU/mL and 24,570 [3,703-106,642] in plasma and bronchoalveolar fluid, respectively. In multivariate analysis, only a cumulative corticosteroids dose of dexamethasone ≥250 mg (HR = 2.042; 95%CI, 1.130-3.688; p = 0.018) was associated with developing CMV reactivation. Conclusion: In critically ill COVID-19 patients, CMV reactivation is frequent and a high cumulative corticosteroids dose is a significant risk factor for CMV reactivation, which is associated with poor outcomes. Further prospective studies are warranted to determine optimal management.
MeSH term(s)	Humans ; Male ; Middle Aged ; COVID-19/epidemiology ; COVID-19/virology ; COVID-19/complications ; Female ; Critical Illness ; Cytomegalovirus Infections/epidemiology ; Cytomegalovirus Infections/drug therapy ; Cytomegalovirus Infections/virology ; Cytomegalovirus Infections/complications ; Risk Factors ; Aged ; Cytomegalovirus/physiology ; Cytomegalovirus/drug effects ; Cytomegalovirus/isolation & purification ; Retrospective Studies ; Prevalence ; SARS-CoV-2/isolation & purification ; SARS-CoV-2/physiology ; Virus Activation/drug effects ; Thailand/epidemiology ; Viral Load
Language	English
Publishing date	2024-05-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0303995
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Article: Epstein-Barr virus, Cytomegalovirus, and Herpes Simplex-1/2 reactivations in critically ill patients with COVID-19.

Mattei, Alessia / Schiavoni, Lorenzo / Riva, Elisabetta / Ciccozzi, Massimo / Veralli, Roberta / Urselli, Angela / Citriniti, Vincenzo / Nenna, Antonio / Pascarella, Giuseppe / Costa, Fabio / Cataldo, Rita / Agrò, Felice Eugenio / Carassiti, Massimiliano

Intensive care medicine experimental

2024 Volume 12, Issue 1, Page(s) 40

Abstract: ... CMV), Epstein-Barr Virus (EBV) reactivations in critically ill COVID-19 patients. To determine ... in critically ill patients with COVID-19 severe Pneumonia are associated with mortality and with a higher risk ... Setting: COVID-19 Intensive Care Unit.: Patients: From November 2020 to May 2021, one hundred and ...

Abstract	Objectives: To assess the incidences of Herpes Simplex-1 and 2 (HSV-1, HSV-2), Cytomegalovirus (CMV), Epstein-Barr Virus (EBV) reactivations in critically ill COVID-19 patients. To determine the association between viral reactivation and in-hospital mortality, Intensive Care Unit Bloodstream infection (ICU-BSI), ventilator-associated pneumonia (VAP). Design: Observational retrospective cohort study. Setting: COVID-19 Intensive Care Unit. Patients: From November 2020 to May 2021, one hundred and twenty patients with COVID-19 severe pneumonia were enrolled and tested for HSV-1, HSV-2, CMV and EBV at the admission in ICU and weekly until discharge or death. The presence of VAP and ICU-BSI was evaluated according to clinical judgement and specific diagnostic criteria. Measurements and main results: One hundred and twenty patients were enrolled. Multiple reactivations occurred in 75/120 (63%) patients, single reactivation in 27/120 patients (23%). The most reactivated Herpesvirus was EBV, found in 78/120 (65%) patients. The multivariate analysis demonstrated that viral reactivation is a strong independent risk factor for in-hospital mortality (OR = 2.46, 95% CI 1.02-5.89), ICU-BSI (OR = 2.37, 95% CI 1.06-5.29) and VAP (OR = 2.64, 95% CI 1.20-5.82). Conclusions: Human Herpesviruses reactivations in critically ill patients with COVID-19 severe Pneumonia are associated with mortality and with a higher risk to develop both VAP and ICU-BSI.
Language	English
Publishing date	2024-04-22
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2740385-3
ISSN	2197-425X
ISSN	2197-425X
DOI	10.1186/s40635-024-00624-9
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Article ; Online: Cytomegalovirus reactivation with high viral load in a patient of coronavirus disease 2019 acute respiratory distress syndrome: a case report.

Pal, Sourav / Garg, Atul / Agarwal, Anupam / Ghoshal, Ujjala / Singh, Pooja / Chahar, Jitendra S / Gurjar, Mohan

Journal of medical case reports

2023 Volume 17, Issue 1, Page(s) 215

Abstract: ... it has been observed that cytomegalovirus reactivation also occurs in critically ill patients ... Cytomegalovirus reactivation has been well reported in immune-compromised patients; however, in the last few years ... Introduction: Cytomegalovirus establishes life-long latency after primary infection in childhood ...

Abstract	Introduction: Cytomegalovirus establishes life-long latency after primary infection in childhood. Cytomegalovirus reactivation has been well reported in immune-compromised patients; however, in the last few years it has been observed that cytomegalovirus reactivation also occurs in critically ill patients without exogenous immunosuppression, which increases length of intensive care unit stay and mortality rate. Case report: A 63-year-old Indian male, without any known comorbidity, developed severe coronavirus disease 2019 and was admitted to the intensive care unit. He received remdesivir, tocilizumab, steroids, anticoagulants, and empiric antibiotics over the next 3 weeks. However, his clinical condition did not improve much, and during the 9th week of illness his condition started deteriorating and routine bacterial cultures, fungal cultures, and cytomegalovirus real-time polymerase chain reaction on blood were negative. His clinical condition worsened rapidly, which led to the need for invasive mechanical ventilation. Tracheal aspirate bacterial and fungal culture showed no growth, but cytomegalovirus real-time polymerase chain reaction showed 21,86,000 copies/mL in tracheal aspirates. After 4 weeks of ganciclovir treatment, the patient improved clinically and was discharged. Currently he is doing well and able to do his routine activity without the need of oxygen. Conclusion: Timely management with ganciclovir is associated with favorable outcome in cytomegalovirus infection. Thus, it can be suggested that treatment should be initiated with ganciclovir if a patient with coronavirus disease 2019 has high cytomegalovirus load in tracheal aspirates, along with unexplained and prolonged clinical and/or radiological features.
MeSH term(s)	Humans ; Male ; Middle Aged ; Cytomegalovirus ; Viral Load ; COVID-19 ; Ganciclovir/therapeutic use ; Respiratory Distress Syndrome ; Antiviral Agents/therapeutic use
Chemical Substances	Ganciclovir (P9G3CKZ4P5) ; Antiviral Agents
Language	English
Publishing date	2023-05-16
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	2269805-X
ISSN	1752-1947 ; 1752-1947
ISSN (online)	1752-1947
ISSN	1752-1947
DOI	10.1186/s13256-023-03819-y
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Article: Fatal cytomegalovirus pneumonia in a critically ill patient with COVID-19.

Amiya, Saori / Hirata, Haruhiko / Shiroyama, Takayuki / Adachi, Yuichi / Niitsu, Takayuki / Noda, Yoshimi / Enomoto, Takatoshi / Hara, Reina / Fukushima, Kiyoharu / Suga, Yasuhiko / Miyake, Kotaro / Koide, Moe / Uchiyama, Akinori / Takeda, Yoshito / Kumanogoh, Atsushi

Respirology case reports

2021 Volume 9, Issue 7, Page(s) e00801

Abstract: ... for routine monitoring for CMV infection in critically ill patients with COVID-19. ... of a critically ill patient with COVID-19 who required reintubation and prolonged MV, and eventually died of secondary ... prolonged invasive mechanical ventilation (MV). COVID-19 patients with severe lymphopenia or respiratory ...

Abstract	Coronavirus disease 2019 (COVID-19) can cause severe lymphopenia and respiratory failure requiring prolonged invasive mechanical ventilation (MV). COVID-19 patients with severe lymphopenia or respiratory failure are at risk of developing secondary infections. Here, we present the needle autopsy findings of a critically ill patient with COVID-19 who required reintubation and prolonged MV, and eventually died of secondary cytomegalovirus (CMV) pneumonia. This case highlights the potential risk of long-term steroid use and the need for routine monitoring for CMV infection in critically ill patients with COVID-19.
Language	English
Publishing date	2021-06-08
Publishing country	United States
Document type	Case Reports
ZDB-ID	2750180-2
ISSN	2051-3380
ISSN	2051-3380
DOI	10.1002/rcr2.801
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Article ; Online: 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

Intensive care medicine

2022 Volume 48, Issue 6, Page(s) 706–713

Abstract: Purpose: Cytomegalovirus (CMV) reactivation in immunocompetent critically ill patients is common ... which, however, does not seem to influence the outcome of COVID-19 ICU patients independently. ... Consecutive patients with confirmed SARS-CoV-2 infection and acute respiratory distress syndrome admitted ...

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.
MeSH term(s)	COVID-19 ; Critical Illness ; Cytomegalovirus/physiology ; Cytomegalovirus Infections/complications ; Cytomegalovirus Infections/epidemiology ; Humans ; Intensive Care Units ; Risk Factors ; SARS-CoV-2
Language	English
Publishing date	2022-05-18
Publishing country	United States
Document type	Journal Article ; Observational Study
ZDB-ID	80387-x
ISSN	1432-1238 ; 0340-0964 ; 0342-4642 ; 0935-1701
ISSN (online)	1432-1238
ISSN	0340-0964 ; 0342-4642 ; 0935-1701
DOI	10.1007/s00134-022-06716-y
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Zs.A 1089: Show issues

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Je nach Verfügbarkeit (siehe Angabe bei Bestand)
bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
Jg. 1995 - 2021: Lesesall (1.OG)
ab Jg. 2022: Lesesaal (EG)

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Article ; Online: Association of COVID-19-Associated Pulmonary Aspergillosis with Cytomegalovirus Replication

Jorge Calderón-Parra / Victor Moreno-Torres / Patricia Mills-Sanchez / Sandra Tejado-Bravo / Isabel Romero-Sánchez / Bárbara Balandin-Moreno / Marina Calvo-Salvador / Francisca Portero-Azorín / Sarela García-Masedo / Elena Muñez-Rubio / Antonio Ramos-Martinez / Ana Fernández-Cruz

Journal of Fungi, Vol 8, Iss 161, p

A Case–Control Study

2022 Volume 161

Abstract: ... were selected for each case among critically ill COVID-19 patients. Results: In total, 24 CAPA cases ... replication was observed prior to CAPA diagnosis. Conclusions: Among critically ill COVID-19 patients, CMV ... aspergillosis in immunocompromised hosts. However, its association with COVID-19-associated ...

Abstract	Introduction: Cytomegalovirus (CMV) infection is a well-known factor associated with invasive aspergillosis in immunocompromised hosts. However, its association with COVID-19-associated pulmonary aspergillosis (CAPA) has not been described. We aimed to examine the possible link between CMV replication and CAPA occurrence. Methods: A single-center, retrospective case–control study was conducted. A case was defined as a patient diagnosed with CAPA according to 2020 ECMM/ISHAM consensus criteria. Two controls were selected for each case among critically ill COVID-19 patients. Results: In total, 24 CAPA cases were included, comprising 14 possible CAPA and 10 probable CAPA. Additionally, 48 matched controls were selected. CMV replication was detected more frequently in CAPA than in controls (75.0% vs. 35.4%, p = 0.002). Probable CMV end-organ disease was more prevalent in CAPA (20.8% vs. 4.2%, p = 0.037). After adjusting for possible confounding factors, CMV replication persisted strongly associated with CAPA (OR 8.28 95% CI 1.90–36.13, p = 0.005). Among 11 CAPA cases with CMV PCR available prior to CAPA, in 9 (81.8%) cases, CMV replication was observed prior to CAPA diagnosis. Conclusions: Among critically ill COVID-19 patients, CMV replication was associated with CAPA and could potentially be considered a harbinger of CAPA. Further studies are needed to confirm this association.
Keywords	COVID-associated pulmonary aspergillosis ; CAPA ; prevalence ; risk factors ; cytomegalovirus infection ; Biology (General) ; QH301-705.5
Subject code	610
Language	English
Publishing date	2022-02-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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