Herpes simplex virus and cytomegalovirus reactivations among severe COVID-19 patients

Cytomegalovirus haemorrhagic enterocolitis associated with severe infection with COVID-19

“… 11 12 This may result in reactivation of herpes simplex virus and CMV in severe COVID-19 disease. 13 Immunophenotyping of plasma lymphocytes in this case confirmed the depletion of subset of T-lymphocytes necessary for adaptive immune response to viral infection. In addition to dysfunction of T-lymphocytes and of cell-mediated immune response to viral infection, other researchers have also indicated that concurrent excessive activation of B-lymphocytes and production of SARS-CoV-2 neutralising antibodies may be associated with an additional tissue injury similar to settings in autoimmune disorders.…”

SARS-CoV-2-Induced ARDS Associates with MDSC Expansion, Lymphocyte Dysfunction, and Arginine Shortage

“…In addition to delaying virus clearance, lymphopenia and/or functional T cell defects also favor secondary infections by opportunistic pathogens inducing prolonged mechanical ventilation responsible for late mortality [ 1 , 11 ]. While sepsis is more often associated with bacterial or fungal infections [ 12 ], COVID-19 can thus feature “viral sepsis” with a pathologic host response characterized by an important cytokine release, and critically ill associated immunosuppression rather than “typical” ARDS [ 13 , 14 ]. Lymphopenia, a crucial component of severe COVID-19, has in fact been noted in other severe respiratory viral infections, notably H1N1 influenza [ 15 ].…”

SARS-CoV-2 infection as a risk factor for herpesviridae reactivation: consider the potential influence of corticosteroid therapy

“…We read with great interest the recent article by Le Balc'h et al who concluded that their results suggest that SARS-CoV-2 infection could be a risk factor for Herpesviridae reactivation [ 1 ]. We would like to make some comments.…”

“…Infections that can arise during glucocorticoid use, and for which preventative measures can be taken, include reactivation of Herpesviridae that can lead to herpetic pneumonia [ 2 ]. In the study of Le Balc'h et al [ 1 ], 44% of patients in the Herpesviridae reactivation group received corticosteroids, compared to only 20% of patients in the non-reactivation group. Although the difference did not reach statistical significance due to the low number of patients, the difference is still notable and may explain, at least in part, the difference in Herpesviridae reactivation between the groups.…”

“…This is equal to a daily dose of 52.5 mg of prednisolone [ 4 ]. The dose of steroid and the duration of treatment are not reported in the Le Balc'h et al study [ 1 ]. Given that a dose of 52.5 mg of prednisolone is equal to 8 mg of dexamethasone, the dose used in the RECOVERY trial (6 mg) [ 5 ] may not increase the risk of reactivation of Herpesviridae .…”