A New Viral Coinfection: SARS-CoV-2 Pneumonia and Cytomegalovirus Pneumonitis in a Renal Transplant Recipient

Abstract

SARS-CoV-2 has caused a global pandemic of an acute respiratory illness known as COVID-19. Patients with solid organ transplants receiving chronic immunosuppressive therapy are at risk of severe disease caused by opportunistic pathogens, including cytomegalovirus (CMV). We present the case of a renal transplant recipient presenting with hypoxic respiratory failure because of severe COVID-19, whose course was complicated by ganciclovir-resistant CMV pneumonitis.

Cytomegalovirus reactivation and recalcitrant oral ulcers following coronavirus disease 2019 infection in a kidney transplant recipient

“…For example, CMV, EBV, and human herpes virus-6 viremia were observed in 20-22%, 82%, and 22% 1,2 respectively among COVID-19 patients admitted to the intensive care unit. In the immunocompromised host, reactivation of these viruses might lead to fulminant clinical diseases like pneumonitis, 3,4 disseminated infection, 5 and allograft dysfunction. 6 Invasive fungal infections most commonly due to aspergillus, mucor, and candida species could befall COVID-19infected transplant patients.…”

What’s New: Updates on Cytomegalovirus in Solid Organ Transplantation

“…Moreover, it is possible that viral coinfection can occur with reports of CMV pneumonitis occurring in the setting of COVID-19. 91 Kidney transplant recipients with CMV and COVID-19 coinfection may experience excess mortality. 92 The authors suggest that regular monitoring of CMV and lymphocyte counts in these patients may be prudent.…”