未经授权:评估重症COVID-19患者呼吸道样本中单纯疱疹和巨细胞病毒感染的患病率,其在SARS-CoV-2感染早期的结局和死亡率以及地塞米松治疗的影响中的作用。
UNASSIGNED:纳入了2020年3月至2021年1月在ICU接受治疗的所有机械通气COVID-19患者。通过定量实时PCR测试呼吸道标本中的单纯疱疹病毒(HSV)1、2型和巨细胞病毒(CMV)。在有和没有HSV-1感染的队列中比较临床参数。
未经证实:134例患者,中位年龄为72.5岁(73.0%为男性,包括n=98)。61例(45.5%)患者发生HSV-1再激活,机械通气后中位数9(7-13)天。再激活的主要因素是在ICU的住院时间(24天比13天,p<0.001)和机械通气持续时间(417vs214小时,p<0.001)。单变量分析中,地塞米松治疗和免疫抑制史与HSV感染无关(39vs41,p=0.462和27.9%vs23.3%,分别为p=0.561)。在有和没有HSV感染的队列中,ICU和医院死亡率没有显着差异(57.4%vs45.2%,p=0.219)。
UNASSIGNED:我们的研究表明,在重症COVID-19患者中,HSV感染的患病率很高,出乎意料地高于CMV感染的患病率,并且与地塞米松治疗无关。研究队列中HSV和CMV的主要危险因素是ICU住院时间和机械通气时间。因此,我们建议对危重COVID-19患者进行这些病毒合并感染的常规监测,并考虑对这些患者进行治疗.
UNASSIGNED: To assess the prevalence of Herpes simplex and Cytomegalovirus infection in respiratory samples of critically-ill COVID-19 patients, its role in outcome and mortality and the influence of dexamethasone treatment in the early stage of SARS-CoV-2 infection.
UNASSIGNED: All mechanically ventilated COVID-19 patients treated on ICU between March 2020 and January 2021 were included. Respiratory specimens were tested for Herpes simplex virus (HSV) type 1, 2 and Cytomegalovirus (CMV) by quantitative real-time PCR. Clinical parameters were compared in the cohorts with and without HSV-1- infection.
UNASSIGNED: 134 patients with a median age of 72.5 years (73.0% male, n=98) were included. HSV-1 reactivation occurred in 61 patients (45.5%), after median 9 (7-13) days of mechanical ventilation. The main factor for reactivation was length of stay on ICU (24 days vs 13 days, p<0.001) and duration of mechanical ventilation (417 vs 214 hours, p<0.001). Treatment with dexamethasone and a history of immunosuppression did not associate with HSV-infection in the univariate analysis (39 vs 41, p=0.462 and 27.9% vs 23.3%, p=0.561, respectively). Both ICU and hospital mortality were not significantly different in the cohorts with and without HSV-infection (57.4% vs 45.2%, p=0.219).
UNASSIGNED: Our study shows a high prevalence of HSV-infection in critically-ill COVID-19 patients which was unexpectedly higher than the prevalence of CMV-infections and unrelated to dexamethasone treatment. The main risk factors for HSV and CMV in the studied cohorts were the length of ICU stay and duration of mechanical ventilation. Therefore, we recommend routine monitoring of critically ill COVID-19 patients for these viral co-infections and consider treatment in those patients.