Maria Jesus Pérez, Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Doctor Esquerdo, 46, 28007 Madrid, Spain.
Rev Esp Quimioter. 2023 Feb;36(1):45-51. doi: 10.37201/req/068.2022. Epub 2022 Nov 22.
To determine the prevalence of CMV reactivation in a population admitted for severe COVID-19 to a general hospital.
Point prevalence study in all hospitalized patients with severe COVID-19 (admitted either to general wards or ICU). Determination of the presence of CMV DNA in circulating blood. COVID-19 was confirmed in patients with compatible clinical manifestations, usually with pneumonia and a positive nasopharyngeal PCR test.
We included 140 hospitalized patients with COVID-19 who consented to participate. A total of 16 patients (11.42%), had circulating CMV-DNA in peripheral blood at the time of the study. Patients with positive CMV viral load were mainly ICU patients (11/37 -29,7%) and only 5/103 cases (4,85%) were hospitalized into general wards. The accumulated doses of corticosteroids (prednisone equivalents) in the study day were (median and IQR) 987.50 mg (396.87-2,454.68) and 187.50 mg (75.00-818.12) respectively in CMV positive and negative patients (p < 0.001). A significant proportion of CMV positive patients were discovered because of the study and were clinically unsuspected by their physicians. The coinfected COVID-CMV positive population had a higher risk of accumulated secondary nosocomially-acquired infections and a worse prognosis.
CMV reactivation should be systematically searched in patients in COVID-19 cases admitted to the ICU.
确定入住综合医院的严重 COVID-19 患者中 CMV 再激活的患病率。
对所有入住综合医院的严重 COVID-19 患者（入住普通病房或 ICU）进行时点患病率研究。确定循环血液中 CMV DNA 的存在。在具有符合临床症状的患者（通常患有肺炎和鼻咽 PCR 检测阳性）中确诊 COVID-19。
我们纳入了 140 名同意参与的 COVID-19 住院患者。在研究时，共有 16 名患者（11.42%）的外周血中存在循环 CMV-DNA。CMV 病毒载量阳性的患者主要是 ICU 患者（11/37-29.7%），仅 5/103 例（4.85%）住院到普通病房。研究日的累积皮质激素（泼尼松等效物）剂量分别为（中位数和 IQR）CMV 阳性和阴性患者分别为 987.50mg（396.87-2454.68）和 187.50mg（75.00-818.12）（p<0.001）。CMV 阳性患者中有相当一部分是因为研究而被发现的，并且其医生在临床上并未怀疑他们患有 CMV 感染。合并感染 COVID-CMV 的阳性人群发生累积性医院获得性二次感染和预后较差的风险更高。
应在入住 ICU 的 COVID-19 患者中系统地搜索 CMV 再激活。
