Arushi Bidhuri
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Written By: Arushi Bidhuri | Updated : July 15, 2021 10:01 PM IST
After Fungal Infections, Cytomegalovirus Reported In Patients
While some people experienced mild to manageable Covid-19 symptoms and recovered at home, others who are older or suffering from another illness are at a higher risk of severe infection. As per studies, one in six patients may even experience complications, including some that are lethal. The medical fraternity is still discovering new complications that come with the virus. When the human body becomes immune to the fatal coronavirus and the medicines used to protect the body against COVID-19, a new form of virus enters the body. The drugs used to treat coronavirus weaken patients' immunity and render the human body vulnerable to rare illnesses. Mucormycosis or black fungus is the most predominant complication that affected many Covid-19 patients, but a new complication is being reported in some patients.
Recent reports have suggested that people infected with Covid-19 are experiencing cytomegalovirus (CMV), which is steadily rising in the country. Cases of the common herpes viral infection have been identified in Delhi, Pune and Bengaluru, making it the most recent post-Covid complication. It has been reported that six patients have been diagnosed with this illness at Indraprastha Apollo Hospitals in Delhi within the last month. Similar infections have been detected in Bengaluru and Pune as well. According to reports, Delhi's Ganga Ram Hospital also reported five cases of CMV in Covid patients. In a written statement, the hospital said four of the five patients experienced gastrointestinal bleeds or bleeding in the stool, while the fifth suffered intestinal blockage. Two of them suffered large bleeds, one requiring emergency lifesaving surgery to remove the right half of the colon, and one died as a result of massive bleeding and severe Covid chest illness, said the statement.
According to Mayo Clinic, once infected with this virus, the body is infected with it for life. The virus seldom causes issues in healthy people but the virus, which is linked to the herpes virus, can have a serious impact on those who have a compromised immune system. We talked to Dr Vikas Maurya, Director and HOD, Pulmonology, Fortis Hospital, Shalimar Bagh.
Cytomegalovirus infection is a herpes virus infection. It is a double-stranded DNA virus that is dormant in the body. We also got a case of CMV in a Covid patient at Fortis. This virus can infect immunocompromised patients, transplant patients, and Covid patients who are on immunosuppressants like steroids so they are at risk of getting this infection. Since they have low immunity, they can get infected with this virus and can get pneumonia, which looks the same as coronavirus' involvement of the lungs. When a person is infected with the virus, the kidney and lungs can mimic the changes of Covid-19. However, it can be treated by antiviral drugs and other suppressant medication.
Previously, the infection was seen in immunocompromised patients or transplant patients who have had liver or kidney transplants, but now it is being seen in patients suffering from Covid-19. Clearly, having some kind of an underlying condition can increase the risk of these complications.
CMV tends to complicate Covid pneumonia and increase the chances of complications, which can increase ventilated requirement and degree of oxygenation in hospitalized patients. Thus, increase the risk of complications and may up mortality rate in patients.
Covid-19 patients may experience the same symptoms as CMV as it mimics the signs of coronavirus in the system. So, fever, cough, shortness of breath and other symptoms may involve the brain and other internal organs. Some people with CMV may not even show any symptoms. So, clinicians should run a test to check for CMV infection.
Patients may have a positive IGG value, meaning that the patient was infected in the past, and people may have antibody levels. In that case, patients do not need treatment. They only need treatment if the patient develops acute CMV infection. In case patients have had transplantation, we need to keep checking their IGG, IGM and viral load levels in case they are showing signs of CMV. They can be asymptomatic or they might have been infected in the past and have antibodies.
CMV is not a new disease and is not exclusive to coronavirus. With the pandemic, people have become more aware of different diseases. Also, clinicians are more aware of what leads to the deterioration of Covid, which has led to more diagnoses. In almost two years of treating Covid patients, we have seen complications such as mucormycosis and several other viral and fungal infections. Apart from cytomegalovirus, fungal infections like aspergillus, mucormycosis, etc. We have also witnessed cases of typhoid and anaerobic infections like a liver abscesses. The use of steroids and immunosuppressants in patients is probably the reason why patients are experiencing these complications.
Yes, people need to take all necessary precautions to avoid any kind of complications. People who are on immunosuppressants need to be aware of the complications, and they should look for signs of viral and fungal infections that may complicate Covid-19. Also, people should not take immunosuppressants without any prescription or the supervision of the doctor. It is essential as they need to be careful about the dose, duration and the type of immunosuppressant they take, especially in case someone develops a secondary infection.
Covid-19 is a new disease, and research is required to understand the virus completely. People need to be extra cautious about their hygiene they should wear masks, practice frequent hand washing and practice other necessary measures to keep infections at bay. Also, patients should consult a physician and take appropriate precautions to avoid deterioration of the disease. Even people suffering from Covid, who are taking immunosuppressants should take proper precautions.
