ArticlePloS one2025
Cytomegalovirus reactivation in mechanically ventilated patients with or without SARS-CoV-2 infection: A retrospective cohort study.
Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Viral Reactivation in Immunocompetent Critically Ill Patients.Microorganisms · 2026Review
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11 authors.
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Abstract
backgroundData comparing the incidence, risk factors and outcomes of cytomegalovirus (CMV) reactivation in SARS-CoV-2 positive and negative patients remain controversial.
designA retrospective cohort study in a tertiary center. PATIENTS: Patients admitted to the intensive care unit between December 2019 and May 2021, under invasive mechanical ventilation for 4 days or more and screened for CMV reactivation were included. MEASUREMENTS: The primary outcome was the incidence of CMV reactivation in SARS-CoV-2 negative and positive patients. Secondary outcomes included risk factors for CMV reactivation in both populations and survival analysis according to CMV reactivation in SARS-CoV-2 negative and positive patients.
resultsCMV reactivation occurred in 34.7% (n = 51/147) of SARS-CoV-2 negative patients and in 45.4% (83/183) of SARS-CoV-2 positive patients (p = 0.08). When considering competing factors, SARS-CoV-2 infection was not associated with CMV reactivation (sub-hazard ratio (SHR) = 1.01 [0.68-1.49], p = 0.98). Treatment with methylprednisolone was significantly associated with CMV reactivation in the unadjusted and adjusted analysis (SHR 2.81 [2.01-3.93] p < 0.001; SHR 2.84 [1.94-4.15] p < 0.001 respectively). Patients combining SARS-CoV-2 infection and CMV reactivation had a significantly higher all-cause mortality. Among patients presenting a CMV reactivation, the administration of ganciclovir was a protective factor for day-60 mortality (HR = 0.4; [0.22-0.74] p = 0.004).
conclusionIn this large retrospective cohort, CMV reactivation was not significantly associated with SARS-CoV-2 infection in patients undergoing invasive mechanical ventilation for at least 4 days. The major risk factor for CMV reactivation was treatment with methylprednisolone. The combination of CMV reactivation with SARS-CoV-2 infection was associated with a higher mortality whereas ganciclovir treatment reduced mortality.
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