Introduction: Cytomegalovirus (CMV) reactivation has long been recognized as an important viral syndrome in the immunocompromised host. The disease is less well described in critically-ill patients. We evaluated the risk factors for the development of CMV reactivation in patients admitted to the intensive care unit (ICU). We also compared the outcomes of CMV reactivation in ICU patients to those of patients with hematological malignancies.Methods: This is a retrospective study composed of three arms: patients admitted to the ICU with reactivation (ICU+/CMV+ arm), patients admitted to the ICU who did not develop CMV reactivation (ICU+/CMV- arm, and patients with hematological malignancies on the hematology ward without CMV reactivation (ICU-/CMV+ arm).Results: Patients who were admitted to ICU for surgical causes had a decreased risk of CMV reactivation. On the other hand, receiving corticosteroids and vasoactive drugs were associated with an increased risk of CMV reactivation with adjusted odds ratios (aOR) of 2.4 and 25.3, respectively. Mortality was higher in ICU+/CMV+ patients compared to ICU-/CMV+ patients. In the ICU+/CMV+ population, male sex and being on mechanical ventilation after CMV reactivation were independent predictors of mortality (aOR 4.6 and 5.0, respectively). Conclusions: CMV reactivation in ICU patients is a potentially serious disease requiring close attention. The findings from our study help in identifying patients in the ICU at risk for CMV reactivation, thereby warranting frequent screening. Patients at high risk of death (male, on mechanical ventilation) should receive prompt treatment and intensive follow-up.
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