Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2021 Sep 30;21(1):1026.
doi: 10.1186/s12879-021-06698-0.

Cytomegalovirus reactivation in immunocompetent mechanical ventilation patients: a prospective observational study

Zhihui Zhang  1   2 , Xuesong Liu  1 , Ling Sang  1 , Sibei Chen  1 , Zhan Wu  1   2 , Jierong Zhang  1   2 , Yining Sun  1   2 , Yongbo Huang  1 , Yonghao Xu  1 , Weiqun He  1 , Yimin Li #  1 , Xiaoqing Liu #  3
Affiliations
Observational Study

Cytomegalovirus reactivation in immunocompetent mechanical ventilation patients: a prospective observational study

Zhihui Zhang et al. BMC Infect Dis. .

Abstract

Background: Cytomegalovirus (CMV) reactivation is associated with adverse prognoses of critically ill patients. However, the epidemiology and predictors of CMV reactivation in immunocompetent patients receiving mechanical ventilation (MV) are not clear. The aim of this study was to investigate the epidemiology and predictors of CMV reactivation in immunocompetent patients requiring MV.

Methods: A single-center, prospective observational study (conducted from June 30, 2017 to July 01, 2018) with a follow-up of 90 days (September 29, 2018) that included 71 CMV-seropositive immunocompetent patients with MV at a 37-bed university hospital general intensive care unit (ICU) in China. Routine detection of CMV DNAemia was performed once a week for 28 days (Days 1, 7, 14, 21, and 28). CMV serology, laboratory findings, and clinical data were obtained during hospitalization.

Results: Among 71 patients, 13 (18.3%) showed CMV reactivation within 28 days in the ICU. The median time to reactivation was 7 days. CMV reactivation was related to various factors, including body mass index (BMI), sepsis, N-terminal pro-b-type natriuretic peptide (NT-proBNP), blood urea nitrogen (BUN), and hemoglobin (Hb) levels (P < 0.05). In the multivariate regression model, BMI, Hb level, and sepsis were independently associated with CMV reactivation patients (P < 0.05). Moreover, the area under the receiver operating characteristic (AUROC) of BMI, Hb, and BMI combined with Hb was 0.69, 0.70, and 0.76, respectively. The duration of MV, hospitalization expense, length of ICU stay, and 90 day all-cause mortality rate in patients with CMV reactivation was significantly higher than in those without CMV reactivation (P < 0.05).

Conclusions: Among immunocompetent patients with MV, the incidence of CMV reactivation was 18.3%. CMV reactivation was associated with several adverse prognoses. BMI, Hb, and sepsis were independent risk factors for CMV reactivation. BMI and Hb may predict CMV reactivation.

Keywords: Critically ill; Cytomegalovirus reactivation; Epidemiology; Immunocompetent; Predictors.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of Patient Enrollment
Fig. 2
Fig. 2
ROC Evaluation of the Predictive Value of BMI and Hb for CMV Reactivation
Fig. 3
Fig. 3
Kaplan–Meier Curves to Assess the Effect of CMV Reactivation on 90 day Survival after ICU Entry
See this image and copyright information in PMC

References

    1. Zuhair M, Smit GSA, Wallis G, Jabbar F, Smith C, Devleesschauwer B, et al. Estimation of the worldwide seroprevalence of cytomegalovirus: a systematic review and meta-analysis. Rev Med Virol. 2019;29(3):e2034. doi: 10.1002/rmv.2034. - DOI - PubMed
    1. Griffiths PD. Burden of disease associated with human cytomegalovirus and prospects for elimination by universal immunisation. Lancet Infect Dis. 2012;12(10):790–798. doi: 10.1016/S1473-3099(12)70197-4. - DOI - PubMed
    1. Griffiths P, Baraniak I, Reeves M. The pathogenesis of human cytomegalovirus. J Pathol. 2015;235(2):288–297. doi: 10.1002/path.4437. - DOI - PubMed
    1. Papazian L, Hraiech S, Lehingue S, Roch A, Chiche L, Wiramus S, et al. Cytomegalovirus reactivation in ICU patients. Intensive Care Med. 2016;42(1):28–37. doi: 10.1007/s00134-015-4066-9. - DOI - PMC - PubMed
    1. Marandu T, Dombek M, Cook CH. Impact of cytomegalovirus load on host response to sepsis. Med Microbiol Immunol. 2019;208(3–4):295–303. doi: 10.1007/s00430-019-00603-y. - DOI - PubMed

Publication types