ArticleCritical care (London, England)2026
Clinical and biological features of CMV reactivation in ARDS: a prospective cohort study.
Article in Critical care (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- Active cytomegalovirus infection in acute respiratory distress syndrome patients: key points requiring attention.Critical care (London, England) · 2026Article
- Bronchoalveolar Lavage Fluid Microbial and Metabolic Alterations Associated with Acute Respiratory Distress Syndrome in Hospitalized Patients with Community-Acquired Pneumonia.Journal of inflammation research · 2026Article
Corrections and comments
- Commented on by
Authors and funding
6 authors.
Funding
Abstract
backgroundCytomegalovirus (CMV) can be reactivated in patients with acute respiratory distress syndrome (ARDS), a condition associated with poor prognosis. However, the biological characteristics and bio-clinical connection of CMV reactivation remain unclear.
methodsCMV reactivation was assessed in ARDS patients upon ICU admission. Clinical characteristics and outcomes were analysed. The primary outcome was 90-day mortality. Multivariate and time-dependent Cox regression analyses were performed. Plasma and bronchoalveolar lavage fluid (BALF) samples were collected for proteomic and metabolomic analyses to explore underlying associations.
resultsIn total, 151 ARDS patients were included; 151 plasma and 48 BALF samples were analysed. During 90-day follow-up, CMV reactivation was observed in 31.1% (47/151) of patients. Patients with CMV reactivation exhibited significantly higher mortality (38.3% vs. 21.2%; hazard ratio [HR] 2.09, 95% confidence interval [CI] 1.12–3.90, P = 0.018). This result remained significant after multivariate regression (adjusted HR 1.97, 95% CI 1.04–3.74, P = 0.037) and time-dependent Cox regression (time-adjusted HR 2.61, 95% CI 1.38–4.94, P = 0.003). Fewer ventilator-free days (mean difference [MD] − 12.48, 95% CI − 17.75 to − 7.22, P < 0.001) and longer ICU stays (MD 16.22, 95% CI 8.36 − 24.09, P = 0.006) were observed in patients with CMV reactivation, which remained significant after regression adjustment, and experienced multiple adverse clinical outcomes. Subgroup analysis of the primary outcome indicated that patients with pulmonary reactivation had a higher risk of mortality. Proteomic analyses revealed suppression of immune, complement, and ribosomal subunit biogenesis pathways in BALF, along with activation of immune responses in plasma in patients with CMV reactivation. Metabolomic analyses revealed significant upregulation of tryptophan metabolism in plasma and pyrimidine metabolism in BALF in the CMV reactivation group. Several biomarkers linked to host immune responses and viral replication, including CXCL5 (correlation coefficient [Corr.] 0.301, P = 0.038), DERPC (Corr. −0.314, P = 0.030) in BALF and PTX3 in blood (Corr. 0.291, P < 0.001) etc. were correlated with increased mortality.
conclusionsPatients with CMV reactivation exhibited a significantly poor clinical prognosis. Distinct host protein expression and metabolic alterations in different sample types were observed in the CMV reactivation group. These findings provide new insights into the impact of CMV reactivation in ARDS patients.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.