Shiraz University of Medical Sciences, Shiraz, Fars, Iran.
Radiology Department, Shiraz University of Medical Sciences, Shiraz, Fars, Iran.
Infect Dis (Lond). 2022 Aug;54(8):543-557. doi: 10.1080/23744235.2022.2070273. Epub 2022 May 6.
Dysfunction of both the innate and the adaptive immune systems is observed in severe coronavirus disease 2019 which, together with administration of immunosuppressive drugs, could lead to cytomegalovirus coinfection or reactivation associated with a poorer outcome. The current study aimed to systematically review the pattern, presentations, clinical course and outcome of patients with severe acute respiratory syndrome coronavirus 2 and cytomegalovirus coinfection.
Three online databases, PubMed, Scopus and Web of Science, were searched, and after excluding duplicates and irrelevant reports, eligible articles were identified. Information about patients' age and gender, comorbidities, presentations of coronavirus disease 2019 and cytomegalovirus, treatment courses and outcomes were extracted.
A total of 34 reports with 59 patients with coinfection were considered to be eligible for data extraction. A majority of patients were middle-aged or elderly (84.5%). More than three-fourths (79.2%) had at least one comorbidity. Cytomegalovirus viremia was documented in 43 patients. The most common end organ involved was the gastrointestinal tract in 13 patients (48.1% of 27 patients with end organ involvement), mostly as cytomegalovirus colitis, followed by the respiratory tract in 12 patients. There was a significant association between intubation and fatal outcome ( = .011).
We comprehensively reviewed published cases with coronavirus disease 2019 and cytomegalovirus reactivation. The findings may assist in appraising signs and symptoms for early suspicion, detection and treatment in patients with unusual clinical courses or with severe, prolonged or unexplained deterioration of end organ function.
在严重的 2019 年冠状病毒病中观察到先天和适应性免疫系统的功能障碍，再加上免疫抑制药物的使用，可能导致巨细胞病毒合并感染或再激活，从而导致预后较差。本研究旨在系统地回顾严重急性呼吸综合征冠状病毒 2 和巨细胞病毒合并感染患者的模式、表现、临床过程和结局。
在 PubMed、Scopus 和 Web of Science 三个在线数据库中进行检索，在排除重复和不相关的报告后，确定符合条件的文章。提取患者的年龄和性别、合并症、2019 年冠状病毒病和巨细胞病毒的表现、治疗过程和结局等信息。
共纳入 34 篇报告，涉及 59 例合并感染患者，符合数据提取标准。大多数患者为中老年人（84.5%）。超过四分之三（79.2%）的患者至少有 1 种合并症。43 例患者有巨细胞病毒血症。受累的终末器官中最常见的是胃肠道，共 13 例（27 例受累终末器官患者中占 48.1%），主要为巨细胞病毒结肠炎，其次是呼吸道 12 例。气管插管与死亡结局之间存在显著关联（ = .011）。
我们全面回顾了已发表的 2019 年冠状病毒病和巨细胞病毒再激活病例。这些发现可能有助于评估具有不典型临床过程或终末器官功能严重、持续或不明原因恶化的患者的体征和症状，以便早期怀疑、检测和治疗。
