COVID-19 and Cytomegalovirus Co-infection: A Challenging Case of a Critically Ill Patient with Gastrointestinal Symptoms
  • Pedro HF Amaral
    Gastrointestinal Surgery Service, Oswaldo Cruz German Hospital, São Paulo-SP, Brazil
  • Bernadete MC Ferreira
    Internal Medicine Service, Oswaldo Cruz German Hospital, São Paulo-SP, Brazil
  • Sergio Roll
    Gastrointestinal Surgery Service, Oswaldo Cruz German Hospital, São Paulo-SP, Brazil
  • Precil DMM Neves
    Internal Medicine Service, Oswaldo Cruz German Hospital, São Paulo-SP, Brazil
  • Luca GA Pivetta
    Gastrointestinal Surgery Service, Oswaldo Cruz German Hospital, São Paulo-SP, Brazil
  • Sara Mohrbacher
    Internal Medicine Service, Oswaldo Cruz German Hospital, São Paulo-SP, Brazil
  • Eduardo RM Dias
    Gastrointestinal Surgery Service, Oswaldo Cruz German Hospital, São Paulo-SP, Brazil
  • Victor AH Sato
    Internal Medicine Service, Oswaldo Cruz German Hospital, São Paulo-SP, Brazil
  • Érico S Oliveira
    Internal Medicine Service, Oswaldo Cruz German Hospital, São Paulo-SP, Brazil
  • Leonardo VB Pereira
    Internal Medicine Service, Oswaldo Cruz German Hospital, São Paulo-SP, Brazil
  • Alessandra M Bales
    Internal Medicine Service, Oswaldo Cruz German Hospital, São Paulo-SP, Brazil
  • Luciana L Nardotto
    Internal Medicine Service, Oswaldo Cruz German Hospital, São Paulo-SP, Brazil
  • Jéssica N Ferreira
    Internal Medicine Service, Oswaldo Cruz German Hospital, São Paulo-SP, Brazil
  • Américo L Cuvello-Neto
    Internal Medicine Service, Oswaldo Cruz German Hospital, São Paulo-SP, Brazil
  • Pedro R Chocair
    Internal Medicine Service, Oswaldo Cruz German Hospital, São Paulo-SP, Brazil

Keywords

Colitis, COVID-19, cytomegalovirus, immunosuppression, intensive care unit

Abstract

COVID-19 is a severe disease that has reached pandemic status. To the best of our knowledge, we describe the first case of COVID-19 and cytomegalovirus (CMV) co-infection in a critically ill patient. We discuss the challenge of establishing the diagnosis as well as the management of tissue-invasive gastrointestinal CMV infection (TI-GI CMV) simulating vascular involvement and intestinal obstruction in a critically ill patient.

VIEW THE ENTIRE ARTICLE

References

  • WHO. Coronavirus disease 2019 (COVID-19) Situation Report – 94. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200423-sitrep-94-covid-19.pdf?sfvrsn=b8304bf0_4 (accessed 1 Aug 2020).
  • Health Ministry, Brazilian Government. COVID19 Painel Coronavirus. https://covid.saude.gov.br (accessed 9 July 2020).
  • Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395(10223):497–506.
  • Patra S, Samal SC, Chacko A, Mathan VI, Mathan MM. Cytomegalovirus infection of the human gastrointestinal tract. J Gastroenterol Hepatol 1999;14(10):973–976.
  • Fakhreddine AY, Frenette CT, Konijeti GG. A practical review of cytomegalovirus in gastroenterology and hepatology. Gastroenterol Res Pract 2019;2019:6156581.
  • Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020;395(10223):507–513.
  • Cheung KS, Hung IF, Chan PP, Lung KC, Tso E, Liu R, et al. Gastrointestinal manifestations of SARS-CoV-2 infection and virus load in fecal samples from a Hong Kong cohort: systematic review and meta-analysis. Gastroenterology 2020;159(1):85–95.
  • Gu J, Han B, Wang J. COVID-19: gastrointestinal manifestations and potential fecal-oral transmission. Gastroenterology 2020;158(6):1518–1519.
  • Han C, Duan C, Zhang S. Digestive symptoms in COVID-19 patients with mild disease severity: clinical presentation, stool viral RNA testing and outcomes. Am J Gastroenterol 2020;115(6):916–923.
  • Bhayana R, Som A, Li ML. Abdominal imaging findings in COVID-19: preliminary observations. Radiology 2020 May 11. doi: 10.1148/radiol. 201908 [Epub ahead of print].
  • D'Ardes D, Boccatonda A, Schiavone C, Santilli F, Guagnano MT, Bucci M, et al. A case of coinfection with SARS-CoV-2 and cytomegalovirus in the era of COVID-19. Eur J Case Rep Intern Med 2020;7(5):001652.
  • Osawa R, Singh N. Cytomegalovirus infection in critically ill patients: a systematic review. Crit Care 2009;13(3):R68.
  • Moss P. "The ancient and the new": is there an interaction between cytomegalovirus and SARS-CoV-2 infection? Immun Ageing 2020;17:14.
  • Views: 1363
    HTML downloads: 4930
    PDF downloads: 669


    Published: 2020-09-02
    Issue: 2020: Vol 7 No 10 (view)


    How to cite:
    1.
    Amaral P, Ferreira B, Roll S, Neves P, pivetta luca, Mohrbacher S, Dias E, Sato V, Oliveira Érico, Pereira L, Bales A, Nardoto L, Ferreira jessica, Cuvello-Neto A, Chocair P. COVID-19 and Cytomegalovirus Co-infection: A Challenging Case of a Critically Ill Patient with Gastrointestinal Symptoms. EJCRIM 2020;7 doi:10.12890/2020_001911.