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Open Access 01-12-2021 | Septicemia | Research

Cytomegalovirus reactivation in immunocompetent mechanical ventilation patients: a prospective observational study

Authors: Zhihui Zhang, Xuesong Liu, Ling Sang, Sibei Chen, Zhan Wu, Jierong Zhang, Yining Sun, Yongbo Huang, Yonghao Xu, Weiqun He, Yimin Li, Xiaoqing Liu

Published in: BMC Infectious Diseases | Issue 1/2021

Abstract

Background

Cytomegalovirus (CMV) reactivation is associated with adverse prognoses of critically ill patients. However, the epidemiology and predictors of CMV reactivation in immunocompetent patients receiving mechanical ventilation (MV) are not clear. The aim of this study was to investigate the epidemiology and predictors of CMV reactivation in immunocompetent patients requiring MV.

Methods

A single-center, prospective observational study (conducted from June 30, 2017 to July 01, 2018) with a follow-up of 90 days (September 29, 2018) that included 71 CMV-seropositive immunocompetent patients with MV at a 37-bed university hospital general intensive care unit (ICU) in China. Routine detection of CMV DNAemia was performed once a week for 28 days (Days 1, 7, 14, 21, and 28). CMV serology, laboratory findings, and clinical data were obtained during hospitalization.

Results

Among 71 patients, 13 (18.3%) showed CMV reactivation within 28 days in the ICU. The median time to reactivation was 7 days. CMV reactivation was related to various factors, including body mass index (BMI), sepsis, N-terminal pro-b-type natriuretic peptide (NT-proBNP), blood urea nitrogen (BUN), and hemoglobin (Hb) levels (P < 0.05). In the multivariate regression model, BMI, Hb level, and sepsis were independently associated with CMV reactivation patients (P < 0.05). Moreover, the area under the receiver operating characteristic (AUROC) of BMI, Hb, and BMI combined with Hb was 0.69, 0.70, and 0.76, respectively. The duration of MV, hospitalization expense, length of ICU stay, and 90 day all-cause mortality rate in patients with CMV reactivation was significantly higher than in those without CMV reactivation (P < 0.05).

Conclusions

Among immunocompetent patients with MV, the incidence of CMV reactivation was 18.3%. CMV reactivation was associated with several adverse prognoses. BMI, Hb, and sepsis were independent risk factors for CMV reactivation. BMI and Hb may predict CMV reactivation.

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Title: Cytomegalovirus reactivation in immunocompetent mechanical ventilation patients: a prospective observational study
Authors: Zhihui Zhang
Xuesong Liu
Ling Sang
Sibei Chen
Zhan Wu
Jierong Zhang
Yining Sun
Yongbo Huang
Yonghao Xu
Weiqun He
Yimin Li
Xiaoqing Liu
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Septicemia
Septicemia
Published in: BMC Infectious Diseases / Issue 1/2021
Electronic ISSN: 1471-2334
DOI: https://doi.org/10.1186/s12879-021-06698-0

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