High incidence of Epstein-Barr virus, cytomegalovirus, and human-herpes virus-6 reactivations in critically-ill patients with Covid-19

Simonnet, Arthur; Engelmann, Ilka; Moreau, Anne-Sophie; Garcia, Bruno; Six, Sophie; Kalioubie, Ahmed El; Robriquet, Laurent; Hober, Didier; Jourdain, Mercé

BACKGROUND: Systemic reactivation of herpesviruses may occur in intensive care unit (ICU) patients and is associated with morbidity and mortality. Data on severe Coronavirus disease-19 (Covid-19) and concomitant reactivation of herpesviruses are lacking. METHODS: We selected patients admitted to ICU for confirmed Covid-19 who underwent systematic testing for Epstein-Barr virus (EBV), cytomegalovirus (CMV) and human-herpes virus-6 (HHV-6) DNAemia while in the ICU. We retrospectively analyzed frequency, timing, duration and co-occurrence of viral DNAemia. RESULTS:Thirty-four patients were included. Viremia with EBV, CMV, and HHV-6 was detected in 28 (82%), 5 (15%), and 7 (22%) patients, respectively. EBV reactivation occurred early after ICU admission and was associated with longer ICU length-of-stay. CONCLUSIONS: While in the ICU, critically-ill patients with Covid-19 are prone to develop reactivations due to various types of herpesviruses.