Abstract：
BACKGROUND: Human cytomegalovirus (HCMV) infection occurs in immunosuppressed individuals and is known to increase mortality. Patients with coronavirus disease 2019 (COVID-19) are often treated with steroids, require intensive care unit (ICU) treatment, and may therefore be at risk for HCMV infection. However, which factors predispose severely ill patients with COVID-19 to HCMV infection and the prognostic value of such infections remain largely unexplored. This study aimed to examine the incidence and potential risk factors of HCMV infection in patients with severe or critical COVID-19 and evaluate the relationship between HCMV infection and mortality.
RESULTS: We used administrative claims data from advanced treatment hospitals in Japan to identify and analyze patients with severe or critical COVID-19. We explored potential risk factors for HCMV infection using multivariable regression models and their contribution to mortality in patients with COVID-19. Overall, 33,151 patients who progressed to severe or critical COVID-19 illness were identified. The incidence of HCMV infection was 0.3-1.7% depending on the definition of HCMV infection. Steroids, immunosuppressants, ICU admission, and blood transfusion were strongly associated with HCMV infection. Furthermore, HCMV infection was associated with patient mortality independent of the observed risk factors for death.
CONCLUSIONS: HCMV infection is a notable complication in patients with severe or critical COVID-19 who are admitted to the ICU or receive steroids, immunosuppressants, and blood transfusion and can significantly increase mortality risk.
RESULTS: We used administrative claims data from advanced treatment hospitals in Japan to identify and analyze patients with severe or critical COVID-19. We explored potential risk factors for HCMV infection using multivariable regression models and their contribution to mortality in patients with COVID-19. Overall, 33,151 patients who progressed to severe or critical COVID-19 illness were identified. The incidence of HCMV infection was 0.3-1.7% depending on the definition of HCMV infection. Steroids, immunosuppressants, ICU admission, and blood transfusion were strongly associated with HCMV infection. Furthermore, HCMV infection was associated with patient mortality independent of the observed risk factors for death.
CONCLUSIONS: HCMV infection is a notable complication in patients with severe or critical COVID-19 who are admitted to the ICU or receive steroids, immunosuppressants, and blood transfusion and can significantly increase mortality risk.
摘要：
背景：人巨细胞病毒（HCMV）感染发生在免疫抑制个体中，并且已知会增加死亡率。2019年冠状病毒病(COVID-19)患者通常接受类固醇治疗，需要重症监护病房(ICU)治疗,因此可能存在HCMV感染的风险。然而,哪些因素会使COVID-19患者易患HCMV感染，以及此类感染的预后价值仍未被研究。本研究旨在探讨严重或危重型COVID-19患者HCMV感染的发生率和潜在危险因素，并评估HCMV感染与死亡率之间的关系。
结果：我们使用日本高级治疗医院的行政索赔数据来识别和分析重症或重症COVID-19患者。我们使用多变量回归模型探讨了HCMV感染的潜在危险因素及其对COVID-19患者死亡率的影响。总的来说,确定了33,151例进展为严重或严重COVID-19疾病的患者。根据HCMV感染的定义，HCMV感染的发生率为0.3-1.7％。类固醇,免疫抑制剂,入住ICU,输血与HCMV感染密切相关。此外，HCMV感染与患者死亡率相关，与观察到的死亡危险因素无关。
结论：HCMV感染是入住ICU或接受类固醇治疗的重症或危重症COVID-19患者的显著并发症，免疫抑制剂,而输血又能显著增加死亡风险。
结果：我们使用日本高级治疗医院的行政索赔数据来识别和分析重症或重症COVID-19患者。我们使用多变量回归模型探讨了HCMV感染的潜在危险因素及其对COVID-19患者死亡率的影响。总的来说,确定了33,151例进展为严重或严重COVID-19疾病的患者。根据HCMV感染的定义，HCMV感染的发生率为0.3-1.7％。类固醇,免疫抑制剂,入住ICU,输血与HCMV感染密切相关。此外，HCMV感染与患者死亡率相关，与观察到的死亡危险因素无关。
结论：HCMV感染是入住ICU或接受类固醇治疗的重症或危重症COVID-19患者的显著并发症，免疫抑制剂,而输血又能显著增加死亡风险。
