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. 2022 Oct 14;22(1):788.
doi: 10.1186/s12879-022-07747-y.

Association between active cytomegalovirus infection and lung fibroproliferation in adult patients with acute respiratory distress syndrome: a retrospective study

Zhihui Zhang #  1   2 , Rujian Li #  1   2 , Yubiao Chen  1   2 , Jierong Zhang  1   2 , Yongxin Zheng  1   2 , Minmin Xu  1   2 , Jiaqi Liang  1   2 , Jiahui Li  1   2 , Yongbo Huang  1 , Yonghao Xu  1 , Weiqun He  1 , Xiaoqing Liu #  3 , Yimin Li #  4
Affiliations

Association between active cytomegalovirus infection and lung fibroproliferation in adult patients with acute respiratory distress syndrome: a retrospective study

Zhihui Zhang et al. BMC Infect Dis. .

Abstract

Background: Cytomegalovirus (CMV) has high seroprevalence, and its active infection is associated with several adverse prognoses in adult patients with acute respiratory distress syndrome (ARDS). However, the role of active CMV infection in ARDS-associated fibroproliferation is unknown. This study aimed at determining the association between active CMV infection and lung fibroproliferation in adult patients with ARDS.

Methods: We retrospectively reviewed the medical records of all adult patients with ARDS who were admitted to the intensive care unit (ICU) from January 2018 to December 2020 at a national university-affiliated hospital in China. Study subjects were divided into active and non-active CMV infection groups based on CMV DNAemia within a 28-day ICU hospitalization. Lung fibroproliferation was measured using chest high-resolution computed tomography (HRCT) and N-terminal peptide of serum procollagen III (NT-PCP-III) within the first 28 days of ICU admission. Pulmonary fibrosis, clinical features, laboratory findings, treatment measures, and clinical outcomes were compared between the two groups.

Results: Among the 87 ARDS patients included in this study, the incidence of active CMV infection was 16.1% within the 28-day ICU admission period. In logistic regression analyze, active CMV infection was found to be associated with higher pulmonary fibrogenesis, pulmonary fibrosis score, and NT-PCP-III level (P < 0.05). The duration of ICU stay in ARDS patients with active CMV infection was significantly higher than in those without active CMV infection (P < 0.05).

Conclusions: Among adult patients with ARDS, active CMV infection was related to poor clinical outcomes. Active CMV infection was associated with ARDS-associated fibroproliferation. Prophylactic and preemptive use of anti-CMV agents on pulmonary fibrosis should be assessed to determine a consensus therapeutic strategy.

Keywords: Acute respiratory distress syndrome; Cytomegalovirus; Fibroproliferation; High-resolution computer tomography; N-terminal peptide of serum procollagen III.

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Conflict of interest statement

None of the authors has any conflict of interest to report.

Figures

Fig. 1
Fig. 1
Flowchart for study subjects enrollment
Fig. 2
Fig. 2
A, B Assessment of pulmonary fibrosis by NT-PCP-III. *P < 0.05; Continuous variables (Plot) were expressed as Median (interquartile ranges)
See this image and copyright information in PMC

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