Effect of Cytomegalovirus Reactivation on Inflammatory Status and Mortality of Older COVID-19 Patients.
Int J Mol Sci
; 24(7)2023 Apr 06.
Article
em En
| MEDLINE
| ID: mdl-37047803
ABSTRACT
Herpesviridae reactivation such as cytomegalovirus (CMV) has been described in severe COVID-19 (COronaVIrusDisease-2019). This study aimed to understand if CMV reactivation in older COVID-19 patients is associated with increased inflammation and in-hospital mortality. In an observational single-center cohort study, 156 geriatric COVID-19 patients were screened for CMV reactivation by RT-PCR. Participants underwent a comprehensive clinical investigation that included medical history, functional evaluation, laboratory tests and cytokine assays (TNF-α, IFN-α, IL-6, IL-10) at hospital admission. In 19 (12.2%) of 156 COVID-19 patients, CMV reactivation was detected. Multivariate Cox regression models showed that in-hospital mortality significantly increased among CMV positive patients younger than 87 years (HR 9.94, 95% CI 1.66-59.50). Other factors associated with in-hospital mortality were C-reactive protein (HR 1.17, 95% CI 1.05-1.30), neutrophil count (HR 1.20, 95% CI 1.01-1.42) and clinical frailty scale (HR1.54, 95% CI 1.04-2.28). In patients older than 87 years, neutrophil count (HR 1.13, 95% CI 1.05-1.21) and age (HR 1.15, 95% CI 1.01-1.31) were independently associated with in-hospital mortality. CMV reactivation was also correlated with increased IFN-α and TNF-α serum levels, but not with IL-6 and IL-10 serum changes. In conclusion, CMV reactivation was an independent risk factor for in-hospital mortality in COVID-19 patients younger than 87 years old, but not in nonagenarians.
Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Infecções por Citomegalovirus
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COVID-19
Tipo de estudo:
Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Aged80
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Humans
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article