Risk Factors for Cytomegalovirus Reactivation and Association With Outcomes in Critically Ill Adults With Sepsis: A Pooled Analysis of Prospective Studies

Author:

Imlay Hannah123ORCID,Dasgupta Sayan2ORCID,Boeckh Michael12,Stapleton Renee D4,Rubenfeld Gordon D5,Chen Ying2,Limaye Ajit P1

Affiliation:

1. Department of Internal Medicine, University of Washington, Seattle, Washington, USA

2. Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA

3. Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA

4. Larner College of Medicine, University of Vermont, Burlington, Vermont, USA

5. Sunnybrook Health Sciences Center, Toronto, Canada

Abstract

Abstract We performed multivariable analysis of potential risk factors (including cytomegalovirus [CMV] reactivation) for clinical outcomes by day 28 (death or continued hospitalization, ventilator-free days, intensive care unit (ICU)-free days, hospital-free days) from pooled cohorts of 2 previous prospective studies of CMV-seropositive adults with sepsis. CMV reactivation at any level, >100 IU/mL, >1000 IU/mL, peak viral load, and area under the curve were independently associated with the clinical outcomes. We identified the potential effect size of CMV on outcomes that could be used as end points for future interventional trials of CMV prevention using antiviral prophylaxis in ICU patients with sepsis.

Funder

National Institutes of Health

National Institute of Allergy and Infectious Diseases

Merck

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Immunology and Allergy

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