Fatal cytomegalovirus pneumonia in a critically ill patient with COVID‐19

Coronavirus disease 2019 (COVID‐19) can cause severe lymphopenia and respiratory failure requiring prolonged invasive mechanical ventilation (MV). COVID‐19 patients with severe lymphopenia or respiratory failure are at risk of developing secondary infections. Here, we present the needle autopsy findings of a critically ill patient with COVID‐19 who required reintubation and prolonged MV, and eventually died of secondary cytomegalovirus (CMV) pneumonia. This case highlights the potential risk of long‐term steroid use and the need for routine monitoring for CMV infection in critically ill patients with COVID‐19.

[1]  A. Kumanogoh,et al.  Predicting recurrence of respiratory failure in critically ill patients with COVID-19: A preliminary study , 2021, Journal of Infection.

[2]  A. Lazzarin,et al.  Secondary infections in patients hospitalized with COVID-19: incidence and predictive factors , 2020, Clinical Microbiology and Infection.

[3]  M. Kuiper,et al.  Ventilation management and clinical outcomes in invasively ventilated patients with COVID-19 (PRoVENT-COVID): a national, multicentre, observational cohort study , 2020, The Lancet Respiratory Medicine.

[4]  R. Attou,et al.  SARS-CoV-2 infection as a risk factor for herpesviridae reactivation: consider the potential influence of corticosteroid therapy , 2020, Critical Care.

[5]  Xiaoying Gu,et al.  Aetiology and prognostic risk factors of mortality in patients with pneumonia receiving glucocorticoids alone or glucocorticoids and other immunosuppressants: a retrospective cohort study , 2020, BMJ Open.

[6]  Joshua R. Peck,et al.  Cytomegalovirus Enterocolitis secondary to experimental COVID-19 therapy , 2020, IDCases.

[7]  S. Roll,et al.  COVID-19 and Cytomegalovirus Co-infection: A Challenging Case of a Critically Ill Patient with Gastrointestinal Symptoms. , 2020, European journal of case reports in internal medicine.

[8]  D. Girelli,et al.  Cytomegalovirus-Induced Gastrointestinal Bleeding and Pancreatitis Complicating Severe Covid-19 Pneumonia: A Paradigmatic Case , 2020, Mediterranean journal of hematology and infectious diseases.

[9]  J. Tadié,et al.  Herpes simplex virus and cytomegalovirus reactivations among severe COVID-19 patients , 2020, Critical Care.

[10]  Liyan Wen,et al.  Kinetics of viral load and antibody response in relation to COVID-19 severity. , 2020, The Journal of clinical investigation.

[11]  G. Cooke,et al.  Bacterial and fungal co-infection in individuals with coronavirus: A rapid review to support COVID-19 antimicrobial prescribing , 2020, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[12]  Y. Arabi,et al.  Cytomegalovirus infection in immunocompetent critically ill adults: literature review , 2016, Annals of Intensive Care.

[13]  T. van der Poll,et al.  Cytomegalovirus reactivation and mortality in patients with acute respiratory distress syndrome , 2016, Intensive Care Medicine.

[14]  P. Griffiths,et al.  The pathogenesis of human cytomegalovirus , 2015, The Journal of pathology.

[15]  C. Cook,et al.  Occult herpes family viral infections are endemic in critically ill surgical patients , 2003, Critical care medicine.