The Association between CMV infection and the COVID-19 clinical outcomes in critically ill patients.

Background : COVID-19 pandemic impacted all areas of daily life, including medical care. In particular, delivering care for critically ill patients in the ICUs during the crisis was challenging given the competing risks of death serious complications from SARS-CoV-2, and the likely higher lethality of Covid-19 in immunocompromised patients. The mortality associated with Coronavirus Disease 2019 is greatly influenced by known risk factors such as elderly age, cardiovascular disease, hypertension, diabetes,and immunosuppression. As cytomegalovirus reactivation in critically ill patients has been linked with higher morbidity and mortality in intensive care settings, it has been suggested that cytomegalovirus reactivation might lead to worse clinical outcomes of patients with COVID-19. This Study aims to assess the frequency of CMV infection in critically-ill COVID-19 patients. Methods: Our Study population consists of 90 critically-ill COVID-19 patients admitted to the ICUs of Alexandria Main University Hospitals. All the patients underwent serological testing for CMV IgG to assess seroprevalence followed by real time PCR testing. Results: CMV IgG seroprevalence rate was 100% Among the CMV reactivated patients ( n = 68), days of hospital stay range from 7-43 days compared to 4-26 days in non CMV reactivated patients ( n =22 ) and there was a statistically significant difference between the two results. 61.8 % of the CMV reactivated patients died compared to 36 % of the patients who died in the non CMV reactivated group and this difference was statistically significant. Conclusion: CMV infection was found to be associated with worse clinical outcomes.