Respiratory failure & ventilation
Pulmonary herpes simplex virus and cytomegalovirus in patients with acute respiratory distress syndrome related to COVID-19
An erratum to this article was published (Intensive Care Med, May 2025 ↗)
Authors' conclusion
In mechanically ventilated COVID-19 patients, HSV reactivations are common, while CMV reactivations were rare. HSV viral load dynamics prior to or without antiviral treatment are associated with mortality. Alveolar inflammation is elevated after HSV reactivation.
Study context
- Population
- Mechanically ventilated COVID-19 patients seropositive for cytomegalovirus (CMV) or herpes simplex virus (HSV), with routine diagnostic bronchoscopy and bronchoalveolar lavage
- Participants
- 156 vs 172
- Exposure
- CMV-seropositive vs HSV-seropositive
- CMV-seropositiven = 156
- HSV-seropositiven = 172
- Outcome
- Incidence and pathogenicity of pulmonary CMV and HSV reactivation (> 104 copies/ml)
Methodological detailsjoint modeling
- Joint modeling
Main finding
As reported in the abstract
Pulmonary reactivation (> 104 copies/ml)
Observational data: associations, not effects.
Further findings
90-day mortality by HSV viral load dynamics prior to or without antiviral treatment
| HR (95% CI) | ||
|---|---|---|
| HSV viral load dynamicsJoint modeling | 1.24 (1.04–1.47) | |
| 0.512Hazard ratio (log scale) |
Alveolar inflammatory biomarkers
- IL-6, IL-1β, granulocyte colony stimulating factor (G-CSF) and tumor necrosis factor (TNF) increased with HSV reactivation
Original publication
Pulmonary herpes simplex virus and cytomegalovirus in patients with acute respiratory distress syndrome related to COVID-19. Intensive Care Med. Published 17 July 2024. doi:10.
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