Cytomegalovirus (CMV) is a new viral infection plaguing recovered Covid patients after several other post-covid ailments. Doctors believe those who have suppressed immunity or have been given steroids to treat severe Covid contract this viral infection.
While a 63-year-old patient on ECMO (advanced life support) developed this infection after recovering from Covid at Apollo, Jayanagar, and subsequently died, another recovered Covid patient in his 50s at Manipal Hospital, Old Airport Road, is currently suffering from the same infection.
The patient at Apollo was diagnosed with CMV after four weeks of suffering from Covid, and had to undergo high-level expensive molecular tests. Lower respiratory tract samples are required for detecting viruses like CMV. He had diabetes, hypertension, and was immunocompromised due to heavy-duty steroids. The risk factors for CMV are the same as they are for fungal infections.
Though it is very difficult to diagnose, when patients are worsening despite being given anti-bacterials and anti-fungals, and there is no clear cause evident, then doctors start hunting for CMV with respiratory secretions, if the suspicion index is high.
Dr Ravindra Mehta, chief of pulmonology and critical care, Apollo Hospitals, and member of BBMP expert committee, said, "CMV is a virus that usually attacks immunocompromised patients and it's seen in post-transplant individuals or people on steroids and other immunosuppressive agents. The reason it is hard to find is because it requires high-level testing and needs the right sample. We did find the virus via a bronchoscopy in a post Covid patient who was on ECMO. But he passed away."
Mehta suggested controlling diabetes and shorter-term steroids for Covid to prevent getting infected with viral infections like CMV. However, Dr Satyanarayana Mysore, HOD, Pulmonology, and Lung Transplant Physician at Manipal Hospital, Old Airport Road, is currently treating a CMV patient with no history of immunosuppression or transplantation. Due to overwhelming Covid disease, he required ventilator support and eventually, was put on ECMO.
"As per our evaluation, the patient is immunocompetent. As the patient’s condition was not improving, bronchoscopy was done and on investigation, CMV Pneumonitis was diagnosed. There were no other manifestations," Mysore said. The doctor said despite not having the usual risk factors for CMV, the patient developed it because severe Covid suppresses cell-mediated immunity.
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