Senior Consultant, Sir Ganga Ram Hospital, Delhi, India.
DNB Student, Sir Ganga Ram Hospital, Delhi, India, Corresponding Author.
J Assoc Physicians India. 2024 Aug;72(8):101-103. doi: 10.59556/japi.72.0489.
Severe pneumonia accounts for 15% of the total severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections, and the affected patients require hospitalization and oxygen support. In addition, 5% of patients with severe coronavirus disease 2019 (COVID-19) experience acute respiratory distress syndrome and sepsis, which contributes to the high mortality rate. Moreover, the risk of severe COVID-19 increases with age and is the highest among elderly people over 70 years of age. Notably, these pneumonia cases can be attributed to the reactivation of latent cytomegalovirus (CMV). We hereby report two cases of patients with COVID-19 who required prolonged mechanical ventilation and were later diagnosed with secondary CMV pneumonia. These cases support the theory that in some patients with severe COVID-19, there is a possibility of CMV reactivation, contributing to the disease's severity and pathogenesis. These cases also highlight the risk involved in using steroids for a long time and the requirement of routine evaluation for CMV infection in patients with COVID-19 who require prolonged mechanical ventilation or have difficulty weaning off from the ventilator support.
严重肺炎占总严重急性呼吸综合征冠状病毒 2 型（SARS-CoV-2）感染的 15%，受影响的患者需要住院和吸氧支持。此外，5%的严重 2019 年冠状病毒病（COVID-19）患者会出现急性呼吸窘迫综合征和败血症，这导致了高死亡率。此外，COVID-19 的严重风险随着年龄的增长而增加，在 70 岁以上的老年人中风险最高。值得注意的是，这些肺炎病例可归因于潜伏的巨细胞病毒（CMV）的再激活。我们在此报告两例 COVID-19 患者，他们需要长时间机械通气，后来被诊断为继发 CMV 肺炎。这些病例支持了这样一种理论，即在一些严重 COVID-19 患者中，CMV 再激活的可能性导致了疾病的严重程度和发病机制。这些病例还突出了长期使用类固醇的风险，以及对于需要长时间机械通气或难以从呼吸机支持中脱机的 COVID-19 患者，常规评估 CMV 感染的必要性。
