In the latest complication after Black Fungus, reports of another disease called Cytomegalovirus (CMV) have surfaced. Recently, six COVID-recovered patients at Delhi’s Indraprastha Apollo Hospitals have been diagnosed with the CMV infection.
All of them had suffered from severe COVID-induced pneumonia in the preceding months and received high doses of steroids to treat the same. Hospital officials said they had also tested negative for COVID at the time of detection of the CMV disease.
CMV cases have also been detected in Mumbai, Pune and Kolkata, with COVID-recovered patients having to return to the hospital for treatment.
Here is everything you need to know about CMV.
1. What is Cytomegalovirus (CMV)?
Also known as Human Herpesvirus 5 (HHV-5), CMV is a common herpesvirus that often causes natural infections in childhood and remains asymptomatic in patients with normal immunity.
Once infected, the virus is retained in the body for life. Most people don’t realise that they have been infected by CMV because it rarely causes problems in healthy people.
The symptoms usually surface only when carriers become immunocompromised, such as those suffering from cancer, AIDS, or those who have recently had transplants.
2. How does COVID-19 cause CMV?
The medicines used to treat COVID-19 such as steroids suppress the natural immunity of patients and reduce the lymphocyte count (6%-10% as against a normal of 20%-40%). This makes them susceptible to infections like CMV.
3. What are the symptoms of CMV?
The symptoms of CMV range from fever and fatigue to severe symptoms involving the eyes, brain or other internal organs. These symptoms include gastrointestinal bleeding (blood in stools), diarrhea, swollen glands, mouth ulcers, inflamed liver and inflammation of the brain (encephalitis).
Dr Athar Ansari, Consultant (Department of Respiratory, Critical Care and Sleep medicine), Indraprastha Apollo Hospitals, told Livemint, “Symptoms of CMV depend on which part of the body it is affecting. If it has direct involvement of lungs, the patient will have a fever, difficulty in breathing, chest pain or cough. The patients that were admitted to Apollo after 20-30 days of testing COVID-19 positive were detected with conditions like hypoxia, inflammation in the lungs and liver, and one of them was a known case of acute myeloid leukemia.”
4. How is CMV transmitted?
CMV spreads between humans via contact with someone who has the disease. Transmission happens through sexual contact and bodily fluids such as urine, blood, saliva, tears, and faeces.
Expecting mothers who develop an active CMV infection during pregnancy can pass on the virus to their babies, which is known as congenital CMV. Children born with it may or may not show symptoms.
5. How can CMV be diagnosed?
Laboratory investigations are essential in diagnosing CMV. Specific blood tests and colonoscopy evaluations can diagnose CMV-caused colitis, which leads to blood in stools.
Presence of CMV can be confirmed by PCR testing for CMV viremia.
Colonic mucosal biopsies stained with Hematoxylin and Eosin (H & E) can also reveal the ‘owl eye appearance’ of intranuclear inclusion bodies that are highly specific for CMV.
Hence, it is important to keep an eye out for blood in stools during post-COVID recovery. If this is noticed, one should get tested immediately.
6. How can CMV be treated?
There is no specific cure for CMV but there are medicines that can help treat the symptoms. However, while this medication can suppress the virus, it cannot remove it completely from the body, as it stays lifelong in your system.
“The majority of patients with CMV colitis who are immunocompetent may need no treatment with antiviral medications because of the severity of side-effects of antiviral drugs such as ganciclovir, there is no evidence that treatment with antiviral medications in these patients will make significant differences in patient outcomes,” Dr Vipulroy Rathod, senior gastroenterologist, Bhatia Hospital Mumbai, told the Indian Express.
(Edited by Yoshita Rao)