2025/07/23 by Umadri Singh, Mohan Gurjar, Atul Garg +6 · 1 voice
Medicine · #Cytomegalovirus and herpesvirus research #Pancreatitis Pathology and Treatment #Parvovirus B19 Infection Studies
paper · pdf · doi:10.1093/ofid/ofaf438
openalex publication_date 2025/07/23 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/29
Abstract Background In recent years, cytomegalovirus (CMV) reactivation has been recognized during the critical illness of apparently nonimmunosuppressed patients, impacting their clinical outcomes. However, no study is available on CMV reactivation among acute necrotizing pancreatitis (ANP) patients. Methods In this prospective cohort study of adult ANP patients requiring intensive care unit admission with apparently immunocompetent and CMV seropositive status, clinical samples were analyzed on a weekly basis for CMV copies. CMV reactivation was considered when the viral load exceeded 1000 copies/mL in plasma. Results During the study period, 284 samples (plasma 149, drain content 125, and necrotic tissue 10) were analyzed from 41 ANP patients. At enrollment, the median (interquartile range) age was 35 (25–40) years, SOFA score was 7 (6–9), and computed tomography severity index of pancreatitis was 10 (6–10). CMV reactivation was detected in the plasma of 13 patients (31.7%) with an average viral load (range) of 3900 (1500–5600) copies/mL. These patients had higher rates of intra-abdominal (92%) and bloodstream infections (77%). Among these individuals, the maximum CMV in plasma was 8180 (7500–38 500) copies/mL and 3200 (2250–4075) copies/mL (P = .01), while in drain samples it was 81 675 (63 750–101 750) copies/mL and 17 250 (6077–41 952) copies/mL (P = .02), in nonsurvivors and survivors, respectively. CMV copies (per mL) in the pancreatic necrosum (n = 7) were higher 29 200 (14 700–47 500) compared with concurrent samples of drain (10 000 [4135–31 250]) and plasma (1500 [0–12 955]) from the same patients (P = .48). Conclusions Up to one-third of ANP patients experienced CMV reactivation. Higher and persistent CMV copies in the clinical samples were associated with poorer clinical outcomes. ClinicalTrials.gov Identifier NCT05898048.