Abstract
The SARS-CoV-2 pandemic has placed great strain on the most developed of health care systems, especially in the context of critical care. Although co-infections with cytomegalovirus (CMV) are frequent in the critically ill due to underlying immune suppression of multiple causes, the impact on COVID-19 patients remains unclear. Furthermore, severe COVID-19 has recently been associated with significant immune suppression, and this may in turn impact CMV reactivation, possibly contributing to clinical course. Nevertheless, multiple confounding factors in these patients will certainly challenge upcoming research. The authors present a case series of five patients admitted to the intensive care unit (ICU) in the context of respiratory failure due to severe COVID-19. All patients evolved with CMV reactivation during ICU stay.
Highlights
The current pandemic caused by SARS-CoV-2 virus infection has provoked an unprecedented health care burden worldwide with an abrupt demand for critical care provision and consequent strain on the intensive care unit (ICU) [1]
Initial diagnostic workup revealed a positive SARS-CoV-2 PCR assay, arterial blood gas examination (ABG) with hypoxemia and chest X-ray with bilateral patchy lung infiltrates. He evolved with acute respiratory distress syndrome (ARDS) in the first 24 h and was transferred to the ICU, where he required invasive mechanical ventilation (IMV) for 22 days
Chest X-ray showed patchy bilateral lung infiltrates. He was transferred to the medical ward with a Venturi Mask 35%, where he evolved with worsening hypoxemia and was admitted to the ICU the day
Summary
The current pandemic caused by SARS-CoV-2 virus infection has provoked an unprecedented health care burden worldwide with an abrupt demand for critical care provision and consequent strain on the intensive care unit (ICU) [1]. D’Ardes et al were the first to report a case of CMV and SARS-CoV-2 co-infection [5]. The potentially adverse effects of CMV co-infection on COVID-19 outcome have been approached by recent publications [2]. Case report publications of CMV co-infection remain relatively scarce [5,6,7,8,9], and the role of COVID-19 itself on CMV reactivation unclear. The authors report a case series of five patients admitted to the ICU due to SARSCoV-2 pneumonia who presented concomitant CMV infection/reactivation during ICU stay
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