Indraprastha Apollo records six cytomegalovirus infection cases in a month
Six persons have been diagnosed with cytomegalovirus (CMV) infection at Indraprastha Apollo Hospital in Delhi within 20 to 30 days of testing positive for coronavirus, officials said on Thursday. All these patients admitted at the hospital had severe COVID-19 pneumonia in the preceding month, received high doses of steroids, but had turned COVID-19 negative at the time of detection of CMV disease, they said.
What is cytomegalovirus infection?
Cytomegalovirus infection is a common herpesvirus infection with a wide range of symptoms. CMV disease is generally found in patients with an immunocompromised status like those who suffer from HIV, low CD4 counts, or are cancer post-transplant patients on immunosuppressive medicines. Suppression of immunity due to COVID-19 gives CMV a chance to attack patients. CMV exists in 80-90% of Indians in asymptomatic form.
CMV symptoms are different for different body parts
Dr. Athar Ansari, Consultant (Department of Respiratory, Critical Care and Sleep Medicine), Indraprastha Apollo Hospitals, said, "In the past month, we have detected CMV in six patients with the post-COVID-19 syndrome that came with varied manifestations." Symptoms of CMV depend on what body part is affected. If it involves lungs, one will have a fever, difficulty in breathing, chest pain, or cough, he said.
CMV has been reported in immunocompetent patients as well
The patients that were admitted to Apollo after 20-30 days of testing COVID-19 positive were detected with conditions like hypoxia, inflammation in the lungs and liver, and one of them was a known case of acute myeloid leukemia, Dr. Ansari said. CMV colitis is a known entity. Although more common in immunocompromised, it has been reported in immunocompetent patients earlier as well, he added.
Steroids can trigger CMV infection in COVID-19 patients
The reason for the activation of CMV in these patients could be COVID-19-induced immunosuppression and high-dose steroid therapy, said Dr. Avdhesh Bansal, Senior Consultant, Department of Respiratory, Critical Care, and Sleep Medicine, Indraprastha Apollo Hospitals. CMV disease can have varied presentations; a high index of suspicion is required to make the diagnosis among COVID-19 patients with persistent symptoms not responding to treatment, he said.