重症脓毒症成年患者巨细胞病毒再激活的危险因素及其与预后的关系：前瞻性研究的汇总分析
Risk Factors for Cytomegalovirus Reactivation and Association With Outcomes in Critically Ill Adults With Sepsis: A Pooled Analysis of Prospective Studies.
作者信息
Imlay Hannah, Dasgupta Sayan, Boeckh Michael, Stapleton Renee D, Rubenfeld Gordon D, Chen Ying, Limaye Ajit P
机构信息
Department of Internal Medicine, University of Washington, Seattle, Washington, USA.
Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
出版信息
J Infect Dis. 2021 Jun 15;223(12):2108-2112. doi: 10.1093/infdis/jiaa697.
Abstract
We performed multivariable analysis of potential risk factors (including cytomegalovirus [CMV] reactivation) for clinical outcomes by day 28 (death or continued hospitalization, ventilator-free days, intensive care unit (ICU)-free days, hospital-free days) from pooled cohorts of 2 previous prospective studies of CMV-seropositive adults with sepsis. CMV reactivation at any level, >100 IU/mL, >1000 IU/mL, peak viral load, and area under the curve were independently associated with the clinical outcomes. We identified the potential effect size of CMV on outcomes that could be used as end points for future interventional trials of CMV prevention using antiviral prophylaxis in ICU patients with sepsis.
摘要
我们对来自之前两项针对巨细胞病毒（CMV）血清学阳性的脓毒症成年患者的前瞻性研究的汇总队列，就第28天的临床结局（死亡或持续住院、无呼吸机天数、无重症监护病房（ICU）天数、无医院天数）的潜在风险因素（包括CMV再激活）进行了多变量分析。任何水平的CMV再激活、>100 IU/mL、>1000 IU/mL、病毒载量峰值和曲线下面积均与临床结局独立相关。我们确定了CMV对结局的潜在效应大小，可将其用作未来针对脓毒症ICU患者使用抗病毒预防措施预防CMV的干预试验的终点。
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