Epidemiological Analysis of Cytomegalovirus Infection in Children: A Five-Year Study

Background: Cytomegalovirus (CMV) is a ubiquitous pathogen of significant medical importance; however, up-to-date data on the prevalence of CMV urinary shedding and seropositivity in children are scarce. Objectives: This study aimed to evaluate the epidemiological traits of human CMV and the implications of the COVID-19 pandemic on its spread. Methods: We retrospectively collected laboratory surveillance data on CMV infection in children aged under 18, comparing the periods before the COVID-19 pandemic (January 2018 to December 2019) and during the pandemic (January 2020 to December 2022). Urine samples were analyzed for CMV DNA using reverse transcription-polymerase chain reaction, and CMV antibodies were detected by chemiluminescence immunoassay. Results: Our cohort included 39,903 children tested for CMV DNA and 70,574 tested for CMV antibodies. The overall prevalence of CMV urine shedding was 16.6%, congenital CMV (cCMV) prevalence was 1.13%, and seroprevalence of IgM and IgG was 3.96% and 85.06%, respectively. Peaks of urinary CMV (uCMV) shedding and IgM antibody production occurred at 3 months to 1 year (67.02%) and 4 weeks to 3 months (11.96%), respectively, both declining sharply with age. Logistic regression indicates that the COVID-19 pandemic independently contributed to a decreased prevalence of urine CMV DNA and CMV IgM, while it led to an increase in the prevalence of CMV IgG. Conclusions: Continuous monitoring and a deeper understanding of CMV's epidemiological characteristics are crucial for preventing CMV infections in children and for the potential development of a multivalent CMV vaccine.