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The relationship between cmv reactivation, anti-cytokine treatment and mortality in critical covid-19 patients
Author(s)
Ramazan Gozukucuk Department of Infectious Disease and Clinical Microbiology, Faculty of Dentist, Istanbul Galata University, Evliya Çelebi, Meşrutiyet Cd. No:62, Beyoglu, Istanbul, 34430 Turkey, Hisar Hospital Intercontinental,Saray Mah. Siteyolu Cad.No:7, Umraniye, Istanbul, 34768 Turkey.
Hasan Huseyin Kilic Department of Anesthesiology and Reanimation, Istanbul Dogus Universty Dudullu Yerleşkesi Dudullu Osb Mah. Nato Yolu Cad. 265/ 1 Ümraniye, Istanbul 34775 Turkey. Hisar Hospital Intercontinental,Saray Mah. Siteyolu Cad.No:7, Umraniye, Istanbul, 34768 Turkey.
Abstract
Objective: To examine the use of anti-cytokine treatment in critical COVID-19 patients and their association with the frequency of CMV cases, viral load level, and mortality in these patients. Methods: This is a retrospective study. A total of 170 critical and/or intensive care patients with COVID-19 admitted to Hisar Hospital Intercontinental from March 15, 2020, to December 31, 2021 were divided into the use of anti-cytokine treatment group and the no anti-cytokine treatment group. Furthermore, the relationship between CMV reactivation, mortality and anti-cytokine treatment in patients was also examined. Results: A total of 170 critical COVID-19 patients were included in the study, three of them were excluded. One hundred sixty seven were included in the study of which 38 (22.7%) were found to be CMV DNA positive. As an anticytokine treatment, it was observed that tocilizumab was used in 53 patients, anakinra was used in 27 patients, and no anti-cytokine treatment was used in 77 patients. CMV positivity in patients treated with anti-cytokines (31.11%) was found to be significantly higher than in patients who were not treated with it (16.88%) (p:0.033). Furthermore, it was determined that anti-cytokine treatment significantly decreased mortality (p: 0.003) and that there was no significant relationship between CMV reactivation and mortality (p: 0.399). Conclusion: Even though CMV reactivation was high in critical COVID-19 patients who received anti-cytokine treatment, decrease in mortality were observed with early diagnosis and efective treatment. Therefore, CMV infection should be considered in patients receiving immunosuppressive treatment.
Publication Details
Page(s) 1286-1290
DOI 10.12669/pjms.39.5.7301
Published Journal: Pakistan Journal of Medical Sciences, Volume: 39, Issue: 5, Year: 2023
Keywords
Mortality COVID19 Tocilizumab Anakinra Anticytokine treatment Cytomegalovirus CMV
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