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. 2024 Apr 22;12(1):40.
doi: 10.1186/s40635-024-00624-9.

Epstein-Barr virus, Cytomegalovirus, and Herpes Simplex-1/2 reactivations in critically ill patients with COVID-19

Alessia Mattei  1 , Lorenzo Schiavoni  2 , Elisabetta Riva  3 , Massimo Ciccozzi  4 , Roberta Veralli  5 , Angela Urselli  1 , Vincenzo Citriniti  1 , Antonio Nenna  6 , Giuseppe Pascarella  1 , Fabio Costa  1 , Rita Cataldo  1 , Felice Eugenio Agrò  1 , Massimiliano Carassiti  1
Affiliations

Epstein-Barr virus, Cytomegalovirus, and Herpes Simplex-1/2 reactivations in critically ill patients with COVID-19

Alessia Mattei et al. Intensive Care Med Exp. .

Abstract

Objectives: To assess the incidences of Herpes Simplex-1 and 2 (HSV-1, HSV-2), Cytomegalovirus (CMV), Epstein-Barr Virus (EBV) reactivations in critically ill COVID-19 patients. To determine the association between viral reactivation and in-hospital mortality, Intensive Care Unit Bloodstream infection (ICU-BSI), ventilator-associated pneumonia (VAP).

Design: Observational retrospective cohort study.

Setting: COVID-19 Intensive Care Unit.

Patients: From November 2020 to May 2021, one hundred and twenty patients with COVID-19 severe pneumonia were enrolled and tested for HSV-1, HSV-2, CMV and EBV at the admission in ICU and weekly until discharge or death. The presence of VAP and ICU-BSI was evaluated according to clinical judgement and specific diagnostic criteria.

Measurements and main results: One hundred and twenty patients were enrolled. Multiple reactivations occurred in 75/120 (63%) patients, single reactivation in 27/120 patients (23%). The most reactivated Herpesvirus was EBV, found in 78/120 (65%) patients. The multivariate analysis demonstrated that viral reactivation is a strong independent risk factor for in-hospital mortality (OR = 2.46, 95% CI 1.02-5.89), ICU-BSI (OR = 2.37, 95% CI 1.06-5.29) and VAP (OR = 2.64, 95% CI 1.20-5.82).

Conclusions: Human Herpesviruses reactivations in critically ill patients with COVID-19 severe Pneumonia are associated with mortality and with a higher risk to develop both VAP and ICU-BSI.

Keywords: Bacteremia; COVID-19; Critically ill; HSV; Mortality; Pneumonia.

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Conflict of interest statement

The authors declare no competing interests.

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References

    1. Papazian L, Fraisse A, Garbe L, et al. Cytomegalovirus. An unexpected cause of ventilator-associated pneumonia. Anesthesiology. 1996;84(2):280–287. doi: 10.1097/00000542-199602000-00005. - DOI - PubMed
    1. Papazian L, Doddoli C, Chetaille B, et al. A contributive result of open-lung biopsy improves survival in acute respiratory distress syndrome patients. Crit Care Med. 2007;35(3):755–762. doi: 10.1097/01.CCM.0000257325.88144.30. - DOI - PubMed
    1. Walton AH, Muenzer JT, Rasche D, et al. Reactivation of multiple viruses in patients with sepsis. PLoS ONE. 2014;9(2):e98819. doi: 10.1371/journal.pone.0098819. - DOI - PMC - PubMed
    1. Huang L, Zhang X, Pang L, et al. Viral reactivation in the lungs of patients with severe pneumonia is associated with increased mortality, a multicenter, retrospective study. J Med Virol. 2023;95(1):e28337. doi: 10.1002/jmv.28337. - DOI - PMC - PubMed
    1. Siciliano RF, Castelli JB, Randi BA, Vieira RD, Strabelli TMV. Cytomegalovirus colitis in immunocompetent critically ill patients. Int J Infect Dis IJID Off Publ Int Soc Infect Dis. 2014;20:71–73. doi: 10.1016/j.ijid.2013.11.008. - DOI - PubMed

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