Impact of cytomegalovirus load on host response to sepsis

Marandu, Thomas F.; Dombek, Michael; Cook, Charles H.

doi:10.1007/s00430-019-00603-y

Cited by 9 publications

(9 citation statements)

References 100 publications

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“…Previous studies had demonstrated that sepsis was associated with CMV reactivation [ 4 , 5 , 15 , 16 ], which was consistent with our results. Sepsis can induce CMV reactivation mainly through sepsis-related cytokine storm triggering transcriptional CMV replication, a mechanism that has been confirmed in animal models [ 4 , 17 , 18 ].…”

Section: Discussionsupporting

confidence: 93%

“…CMV can reactivate in the course of diminished immunity and frailty [ 3 , 4 ]. Critically ill patients have severe diseases (such as sepsis, burns, and acute respiratory distress syndrome) and impaired immune function [ 5 – 7 ]. CMV is prone to reactivation in ICU patients [ 2 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…Some studies have shown that CMV reactivation may be associated with sepsis, transfusion, and cytokine levels. Still, none of them screened out effective indicators to predict CMV reactivation [ 4 , 5 , 8 , 11 ]. Therefore, there is an urgent need to find indicators that can effectively predict CMV reactivation and further study the epidemiology of CMV reactivation in immunocompetent patients requiring MV.…”

Section: Introductionmentioning

confidence: 99%

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Cytomegalovirus reactivation in immunocompetent mechanical ventilation patients: a prospective observational study

et al. 2021

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Background Cytomegalovirus (CMV) reactivation is associated with adverse prognoses of critically ill patients. However, the epidemiology and predictors of CMV reactivation in immunocompetent patients receiving mechanical ventilation (MV) are not clear. The aim of this study was to investigate the epidemiology and predictors of CMV reactivation in immunocompetent patients requiring MV. Methods A single-center, prospective observational study (conducted from June 30, 2017 to July 01, 2018) with a follow-up of 90 days (September 29, 2018) that included 71 CMV-seropositive immunocompetent patients with MV at a 37-bed university hospital general intensive care unit (ICU) in China. Routine detection of CMV DNAemia was performed once a week for 28 days (Days 1, 7, 14, 21, and 28). CMV serology, laboratory findings, and clinical data were obtained during hospitalization. Results Among 71 patients, 13 (18.3%) showed CMV reactivation within 28 days in the ICU. The median time to reactivation was 7 days. CMV reactivation was related to various factors, including body mass index (BMI), sepsis, N-terminal pro-b-type natriuretic peptide (NT-proBNP), blood urea nitrogen (BUN), and hemoglobin (Hb) levels (P < 0.05). In the multivariate regression model, BMI, Hb level, and sepsis were independently associated with CMV reactivation patients (P < 0.05). Moreover, the area under the receiver operating characteristic (AUROC) of BMI, Hb, and BMI combined with Hb was 0.69, 0.70, and 0.76, respectively. The duration of MV, hospitalization expense, length of ICU stay, and 90 day all-cause mortality rate in patients with CMV reactivation was significantly higher than in those without CMV reactivation (P < 0.05). Conclusions Among immunocompetent patients with MV, the incidence of CMV reactivation was 18.3%. CMV reactivation was associated with several adverse prognoses. BMI, Hb, and sepsis were independent risk factors for CMV reactivation. BMI and Hb may predict CMV reactivation.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Cytomegalovirus reactivation in immunocompetent mechanical ventilation patients: a prospective observational study

et al. 2021

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“…The potential mechanism is that reactivated viral microRNAs might be involved in sepsis by functional mimicry mechanisms with cellular microRNAs produced by the human genome, sharing the regulation of the same signalling pathways and regulating the same spectrum of microRNAs. For cytomegalovirus, the proportion of its reactivation in immunocompetent patients was around 30% and has become an area of increasing interest in recent years [101]. Previous studies provided the possibility for the causal relationship between cytomegalovirus reactivation and clinical outcomes among immunocompetent patients with sepsis [102].…”

Section: Host Immune Response To Respiratory Virusmentioning

confidence: 99%

Respiratory viral sepsis: epidemiology, pathophysiology, diagnosis and treatment

Zhou

Wang

et al. 2020

Eur Respir Rev

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According to the Third International Consensus Definition for Sepsis and Septic Shock, sepsis is a life-threatening organ dysfunction resulting from dysregulated host responses to infection. Epidemiological data about sepsis from the 2017 Global Burden of Diseases, Injuries and Risk Factor Study showed that the global burden of sepsis was greater than previously estimated. Bacteria have been shown to be the predominant pathogen of sepsis among patients with pathogens detected, while sepsis caused by viruses is underdiagnosed worldwide. The coronavirus disease that emerged in 2019 in China and now in many other countries has brought viral sepsis back into the vision of physicians and researchers worldwide. Although the current understanding of the pathophysiology of sepsis has improved, the differences between viral and bacterial sepsis at the level of pathophysiology are not well understood. Diagnosis methods that can broadly differentiate between bacterial and viral sepsis at the initial stage after the development of sepsis are limited. New treatments that can be applied at clinics for sepsis are scarce and this situation is not consistent with the growing understanding of pathophysiology. This review aims to give a brief summary of current knowledge of the epidemiology, pathophysiology, diagnosis and treatment of viral sepsis.

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“…CMV can reactivate in the course of diminished immunity and frailty [3,4]. Critically ill patients have severe diseases (such as sepsis, burns, and acute respiratory distress syndrome) and impaired immune function [5][6][7]. CMV is prone to reactivation in ICU patients [2,4].…”

Section: Introductionmentioning

confidence: 99%

Cytomegalovirus Reactivation in Immunocompetent Mechanical Ventilation Patients: A Prospective Observational Study

Zhang

Liu

Sang

et al. 2021

Preprint

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Background: Cytomegalovirus (CMV) reactivation is associated with adverse prognoses of critically ill patients. However, the epidemiology and predictors of CMV reactivation in immunocompetent patients receiving mechanical ventilation (MV) are not clear. The aim of this study was to investigate the epidemiology and predictors of CMV reactivation in immunocompetent patients requiring MV.Methods: A single-center, prospective observational study (conducted from June 30, 2017 to July 01, 2018) with a follow-up of 90 days (September 29, 2018) that included 71 CMV-seropositive immunocompetent patients with MV at a 37-bed university hospital general intensive care unit (ICU) in China. Routine detection of CMV DNAemia was performed once a week for 28 days (Days 1, 7, 14, 21, and 28). CMV serology, laboratory findings, and clinical data were obtained during hospitalization.Results: Among 71 patients, 13 (18.3%) showed CMV reactivation within 28 days in the ICU. The median time to reactivation was 7 days. CMV reactivation was related to various factors, including body mass index (BMI), sepsis, N-terminal pro-b-type natriuretic peptide (NT-proBNP), blood urea nitrogen (BUN), and hemoglobin (Hb) levels (P < 0.05). In the multivariate regression model, BMI, Hb level, and sepsis were independently associated with CMV reactivation patients (P < 0.05). Moreover, the area under the receiver operating characteristic (AUROC) of BMI, Hb, and BMI combined with Hb was 0.69, 0.70, and 0.76, respectively. The duration of MV, hospitalization expense, length of ICU stay, and 90-day all-cause mortality rate in patients with CMV reactivation was significantly higher than in those without CMV reactivation (P < 0.05).Conclusions: Among immunocompetent patients with MV, the incidence of CMV reactivation was 18.3%. CMV reactivation was associated with several adverse prognoses. BMI, Hb, and sepsis were independent risk factors for CMV reactivation. BMI and Hb may predict CMV reactivation.

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Impact of cytomegalovirus load on host response to sepsis

Cited by 9 publications

References 100 publications

Cytomegalovirus reactivation in immunocompetent mechanical ventilation patients: a prospective observational study

Cytomegalovirus reactivation in immunocompetent mechanical ventilation patients: a prospective observational study

Respiratory viral sepsis: epidemiology, pathophysiology, diagnosis and treatment

Cytomegalovirus Reactivation in Immunocompetent Mechanical Ventilation Patients: A Prospective Observational Study

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