Multiuser Laboratory for Research Support in Nephrology and Medical Sciences, Faculty of Medicine, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil.
Postgraduation Program in Medical Sciences, Faculty of Medicine, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil.
J Med Virol. 2022 Mar;94(3):1212-1216. doi: 10.1002/jmv.27392. Epub 2021 Oct 19.
Human herpesvirus-6 (HHV-6) may cause serious diseases in immunocompromised individuals. SARS-CoV-2/HHV-6 coinfection has been emphasized in previous works, mostly case reports, small series, or epidemiological studies, but few are known about its real clinical outcomes. Here we present a real-world pilot study aiming to understand the frequency and the clinical impact of HHV-6 coinfection in moderate to critically ill patients hospitalized due to COVID-19. SARS-CoV-2 and HHV-6 were evaluated in nasopharyngeal samples at the hospital admission of suspected COVID-19 patients. From 173 consecutive cases, 60 were SARS-CoV-2 positive and 13/60 (21.7%) were HHV-6 positive after identified as the HHV-6B species by a Sanger sequencing. The SARS-CoV-2+/HHV-6+ group was younger but not significant for cardiovascular diseases, diabetes, obesity, and cancer, but significant among therapeutic immunosuppressed patients (as systemic lupus erythematosus and kidney transplant patients). In the medical records, only sparse data on cutaneous or neurological manifestations were found. Biochemical and hematological data showed only a trend towards hyperferritinemic status and lymphopenia. In conclusion, despite the impressive high frequency of HHV-6 coinfection in SARS-CoV-2 positive cases, it did not impact general mortality. We suggest larger future prospective studies to better elucidate the influence of HHV-6 reactivation in cases of COVID-19, designed to specific assessment of clinical outcomes and viral reactivation mechanisms.
人疱疹病毒 6 型（HHV-6）可导致免疫功能低下个体发生严重疾病。此前的研究主要为病例报告、小系列研究或流行病学研究，强调了严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）与 HHV-6 的合并感染，但关于其真实临床结局的研究却知之甚少。本研究旨在了解 COVID-19 住院中度至重症患者中 HHV-6 合并感染的频率及其对临床的影响，开展了一项真实世界的试点研究。在疑似 COVID-19 患者入院时，对鼻咽拭子样本进行 SARS-CoV-2 和 HHV-6 检测。在 173 例连续病例中，60 例 SARS-CoV-2 阳性，经 Sanger 测序鉴定为 HHV-6B 种后，13/60（21.7%）为 HHV-6 阳性。SARS-CoV-2+/HHV-6+组患者年龄较小，但心血管疾病、糖尿病、肥胖和癌症的比例无统计学差异，在接受治疗性免疫抑制的患者（如系统性红斑狼疮和肾移植患者）中比例显著更高。在病历中，仅发现皮肤或神经表现的稀疏数据。生化和血液学数据仅显示出铁蛋白血症和淋巴细胞减少的趋势。总之，尽管 SARS-CoV-2 阳性病例中 HHV-6 合并感染的频率高得令人印象深刻，但并未影响总体死亡率。我们建议未来开展更大规模的前瞻性研究，以更好地阐明 COVID-19 病例中 HHV-6 再激活的影响，旨在对临床结局和病毒再激活机制进行特定评估。
