Parvovirus Reactivation in COVID-19

Lai, Peter Y; Vu, Alan; Sarva, S.; Jayaraman, Gnananandh; Kesavan, Ramesh

doi:10.7759/cureus.17796

Cited by 2 publications

(4 citation statements)

References 5 publications

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“…While CMV, HAdV, HHV-6, and BKPyV DNAemia conferred a significant risk of mortality, plasma DNAemia with HSV-1 and B19V were detected less often than the other viruses and were not associated with mortality. Our findings align with reports that only 2% to 10% of children are exposed to B19V before 5 years of age and that clinically significant reactivation is rare …”

Section: Discussioncontrasting

confidence: 62%

“…Our findings align with reports that only 2% to 10% of children are exposed to B19V before 5 years of age and that clinically significant reactivation is rare. 31 , 32 , 33 , 34 …”

Section: Discussionmentioning

confidence: 99%

“…Our findings align with reports that only 2% to 10% of children are exposed to B19V before 5 years of age and that clinically significant reactivation is rare. [31][32][33][34] Torque teno virus is commonly detected in patients in the ICU, 9 and studies have suggested a direct correlation of TTV level with degree of T-cell dysfunction in patients undergoing hematopoietic cell transplant 35 and solid organ transplant. 36 Previous studies have not examined the association between TTV and mortality; our present study did not find higher levels of TTV associated with mortality.…”

Section: Jama Network Open | Critical Care Medicinementioning

confidence: 99%

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Viral DNAemia and DNA Virus Seropositivity and Mortality in Pediatric Sepsis

Cabler,

Storch,

Weinberg

et al. 2024

JAMA Netw Open

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ImportanceSepsis is a leading cause of pediatric mortality. Little attention has been paid to the association between viral DNA and mortality in children and adolescents with sepsis.ObjectiveTo assess the association of the presence of viral DNA with sepsis-related mortality in a large multicenter study.Design, Setting, and ParticipantsThis cohort study compares pediatric patients with and without plasma cytomegalovirus (CMV), Epstein-Barr virus (EBV), herpes simplex virus 1 (HSV-1), human herpesvirus 6 (HHV-6), parvovirus B19 (B19V), BK polyomavirus (BKPyV), human adenovirus (HAdV), and torque teno virus (TTV) DNAemia detected by quantitative real-time polymerase chain reaction or plasma IgG antibodies to CMV, EBV, HSV-1, or HHV-6. A total of 401 patients younger than 18 years with severe sepsis were enrolled from 9 pediatric intensive care units (PICUs) in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network. Data were collected from 2015 to 2018. Samples were assayed from 2019 to 2022. Data were analyzed from 2022 to 2023.Main Outcomes and MeasuresDeath while in the PICU.ResultsAmong the 401 patients included in the analysis, the median age was 6 (IQR, 1-12) years, and 222 (55.4%) were male. One hundred fifty-four patients (38.4%) were previously healthy, 108 (26.9%) were immunocompromised, and 225 (56.1%) had documented infection(s) at enrollment. Forty-four patients (11.0%) died in the PICU. Viral DNAemia with at least 1 virus (excluding TTV) was detected in 191 patients (47.6%) overall, 63 of 108 patients (58.3%) who were immunocompromised, and 128 of 293 (43.7%) who were not immunocompromised at sepsis onset. After adjustment for age, Pediatric Risk of Mortality score, previously healthy status, and immunocompromised status at sepsis onset, CMV (adjusted odds ratio [AOR], 3.01 [95% CI, 1.36-6.45]; P = .007), HAdV (AOR, 3.50 [95% CI, 1.46-8.09]; P = .006), BKPyV (AOR. 3.02 [95% CI, 1.17-7.34]; P = .02), and HHV-6 (AOR, 2.62 [95% CI, 1.31-5.20]; P = .007) DNAemia were each associated with increased mortality. Two or more viruses were detected in 78 patients (19.5%), with mortality among 12 of 32 (37.5%) who were immunocompromised and 9 of 46 (19.6%) who were not immunocompromised at sepsis onset. Herpesvirus seropositivity was common (HSV-1, 82 of 246 [33.3%]; CMV, 107 of 254 [42.1%]; EBV, 152 of 251 [60.6%]; HHV-6, 253 if 257 [98.4%]). After additional adjustment for receipt of blood products in the PICU, EBV seropositivity was associated with increased mortality (AOR, 6.10 [95% CI, 1.00-118.61]; P = .049).Conclusions and RelevanceThe findings of this cohort study suggest that DNAemia for CMV, HAdV, BKPyV, and HHV-6 and EBV seropositivity were independently associated with increased sepsis mortality. Further investigation of the underlying biology of these viral DNA infections in children with sepsis is warranted to determine whether they only reflect mortality risk or contribute to mortality.

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Section: Discussioncontrasting

confidence: 62%

“…Our findings align with reports that only 2% to 10% of children are exposed to B19V before 5 years of age and that clinically significant reactivation is rare. 31 , 32 , 33 , 34 …”

Section: Discussionmentioning

confidence: 99%

Section: Jama Network Open | Critical Care Medicinementioning

confidence: 99%

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Viral DNAemia and DNA Virus Seropositivity and Mortality in Pediatric Sepsis

Cabler,

Storch,

Weinberg

et al. 2024

JAMA Netw Open

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“…COVID-19-associated AIHA has been previously described [ 1 , 2 ], Furthermore, this patient had evidence of recent parvovirus B19-mediated pure red cell aplasia, which significantly worsened his anemia in the setting of ongoing hemolysis. Co-infection with SARS-CoV-2 and parvovirus B19 has been found to cause severe cardiac, neurologic, and hematologic manifestations [ 3 , 4 , 5 , 6 , 7 ].…”

Section: Discussionmentioning

confidence: 99%

Warm Autoimmune Hemolytic Anemia and Pure Red Cell Aplasia during a Severe COVID-19 B.1.1.7 Infection

Ghimire

Platnich

Chauhan

2022

Infectious Disease Reports

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Warm autoimmune hemolytic anemia (AIHA) is a rare complication of COVID-19 infection. We report a case of warm AIHA in a patient with COVID-19 pneumonia treated with methylprednisolone and several red blood cell transfusions. Despite treatment of the warm AIHA, the patient’s reticulocyte count remained low, and his biochemical markers were suggestive of pure red cell aplasia, which was later attributed to a concurrent parvovirus B19 infection. This case highlights an unusual situation of two separate hematological processes caused by two separate and simultaneous viral infections.

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Parvovirus Reactivation in COVID-19

Cited by 2 publications

References 5 publications

Viral DNAemia and DNA Virus Seropositivity and Mortality in Pediatric Sepsis

Viral DNAemia and DNA Virus Seropositivity and Mortality in Pediatric Sepsis

Warm Autoimmune Hemolytic Anemia and Pure Red Cell Aplasia during a Severe COVID-19 B.1.1.7 Infection

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