Cytomegalovirus reactivation in severe respiratory infections of different etiology

Abstract

The present study is aimed at determining the frequency and the characteristic features of reactivation of latent cytomegalovirus infection in patients with severe respiratory infections depending on the etiology of the pathogen. The study included 72 patients with severe bacterial and viral respiratory tract lesions. Cytomegalovirus (CMV) reactivation was determined by the detection of DNA in sputum together with the presence of IgG in blood plasma. The study found differences in the frequency of CMV reactivation in sputum of bacterial, bacterial-viral, and viral pneumonia (36.1%, 50.0%, and 20.0%, respectively). These results indicate that nosocomial bacterial flora may be a risk factor for CMV reactivation. Statistically significant differences were also found in the period of CMV reactivation depending on the etiology of the respiratory tract lesion. In the COVID-19 patients CMV was found in their sputum on days 1-7 (Me 3.0 days), in the bacterial-viral group – on days 1-20 (Me 10.0 days), and in the bacterial pneumonia group – on days 1-52 (Me – 20.0 days). Characteristic features in the dynamics of CMV viral load in the sputum of patients with different etiology of respiratory infections are described. The results indicate a different mechanism of CMV reactivation in case of COVID-19.

Keywords

• cytomegalovirus
• reactivation
• covid-19
• pneumonia
• sepsis
• immunosuppression
• sputum.