The Relationship Between CMV* Reactivation and Anti-cytokine Treatment in Critical COVID-19 Patients (Cytomegalovir)

Ramazan Gozukucuk

Status: Completed

Conditions: COVID-19, Cytomegalovirus (CMV), Tocilizumab, Anakinra, Mortality

Treatments: Diagnostic Test: CMV DNA analysis

Study type: Observational

Funder types: Other

Identifiers

NCT05419206

HisarIH-101

Details and patient eligibility

About

The risk of secondary infection is high in critical patients hospitalized with the diagnosis of COVID-19. Immunosuppressive treatments are commonly used in critical COVID-19 patients, and immune dysfunction and CMV reactivation can be unnoticed in these patients.

Full description

The records of critical patients were reviewed retrospectively. Whether these patients used tocilizumab and/or anakinra and their relationship with CMV reactivation were examined. Furthermore, the relationship between CMV reactivation and mortality and anti-cytokine treatment in patients was also examined. A total of 167 critical COVID-19 patients were included in the study, of which 38 (22.7%) were found to be CMV DNA positive. CMV positivity in patients treated with anti-cytokines (31.11%) was found to be significantly higher than in patients who were not treated with it (16.88%) (p:0.033). There was no significant difference in viral load levels (p:0.513). Furthermore, it was determined that anti-cytokine treatment significantly decreased mortality (p: 0.003) and that there was no significant relationship between CMV reactivation and mortality (p: 0.399). Even though CMV reactivation was high in critical COVID-19 patients who received anti-cytokine treatment, positive developments in morbidity and mortality were observed with early diagnosis and effective treatment.

Enrollment: 167 patients

Sex: All

Ages: 18 to 90 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Critically ill patients over the age of 18 diagnosed with COVID-19 and patients followed in the intensive care unit.

Exclusion criteria

• Patients under the age of 18 with a mild/moderate course of COVID-19,
• CMV PCR positive before anti-cytokine treatment,
• patients who underwent hematopoietic stem cell transplantation

Trial design

167 participants in 2 patient groups

COVID-19 cases with anticytokine therapy

Description:

Considering the use of anti-cytokines in these patients, it was found that 53 received tocilizumab, 27 received anakinra, and 10 received both. CMV DNA was positive in 38 (22.7%) of the patients included in the study. CMV positivity was found to be significantly higher in 90 patients (31.11%) compared to 77 patients (16.88%) who did not receive anti-cytokine treatment (p:0.033)

Treatment:

Diagnostic Test: CMV DNA analysis

COVID-19 cases without anticytokine therapy

Description:

MV positivity was found to be significantly higher in 90 patients (31.11%) compared to 77 patients (16.88%) who did not receive anti-cytokine treatment (p:0.033)

Treatment:

Diagnostic Test: CMV DNA analysis