What is ‘cytomegalovirus’ in post COVID-19 patients? Here are symptoms, treatment

New Delhi: The world and the medical fraternity are still discovering something new about the COVID-19 virus and the complications revolving it. Everyday some kind of learning and un-learning is happening regarding the virus, the complications that come with it and the treatment.

Many COVID-19 patients have been facing post COVID-19 complications and the most predominant one being ‘Mucormycosis’ or the black fungus.

Among the many threats associated with the COVID infection, it has now been learnt that cytomegalovirus (CMV) is steadily on the rise.

Sporadic cases of cytomegalovirus (CMV) are being reported from Delhi, Pune, Bengaluru making it the latest post-COVID complication. In Delhi, six people have been diagnosed with this infection at Indraprastha Apollo Hospitals in a month. A similar infection has been reported from Bengaluru and Pune.

What is ‘cytomegalovirus’?

Cytomegalovirus infection is a common herpes virus infection which may or may not have symptoms. It is a double-stranded DNA virus which remains latent in the body. All those who have so far reported this infection have COVID-19 not even a month before. And by the time, this infection got detected, they tested negative for COVID.

The reason is the suppression of immunity due to the COVID infection, and excessive use of steroids that gives CMV a chance to attack patients.

Symptoms you should look for:

Patients may not have any symptoms, so it is difficult to detect the infection. It may have severe symptoms involving the eyes, brain, or other internal organs. This is not a new infection and, like most other post-COVID complications, this is not exclusive to COVID. As mucormycosis is a fungal infection which may attack when the blood sugar is very high, cytomegalovirus infects when the immunity is compromised. The patient may have fever, difficulty in breathing if the infection attacks the lungs.

The infection is common among those who suffer from HIV, low CD4 counts or are cancer post-transplant patients on immunosuppressive medicines etc.

Though most of them might not show significant symptoms, some of the evident ones are:

– Fever
– Night sweats
– Swollen glands
– Joint and muscle pain
– Low appetite and weight loss

As per a report by The Indian Express, Dr Kirti Sabnis, Infectious Disease Specialist at Fortis Hospitals, Mulund and Kalyan, Mumbai, explains that CMV, or Human Herpesvirus 5 (HHV-5) is one of the “most common persistent infections”.

“CMV occurs as a natural infection in childhood and remains asymptomatic in patients with normal immunity. Once infected, your body retains the virus for life. Most people don’t know they have CMV because it rarely causes problems. It usually affects those who are immuno-compromised, like suffering from cancer, AIDS, or those who have recently had transplants.

“A person can catch CVM infection through contact with an infected person’s saliva, blood, urine, semen, vaginal fluids, or breast milk,” she says.

According to the doctor, the COVID infection itself — and the medicines used for its treatment (steroids) — suppresses the immunity of patients and makes them susceptible to uncommon infections.

“All patients presented with low lymphocyte count (6 per cent to 10 per cent as against a normal of 20 per cent to 40 per cent) indicating COVID-induced suppression of immunity can be predisposed to symptomatic reactivation of CMV infection.

Dr Sabnis also says the symptoms generally go away after two weeks. “Symptoms of recurring CMV, however, vary depending on which organs the virus has affected. Areas likely to be affected are the eyes, lungs, or digestive system.

She then cautioned that a person “with a weakened immune system, who experiences any of these symptoms, should seek urgent medical attention”. People who have battled severe COVID should be cautious.

In May, Congress leader and Rajya Sabha member Rajeev Satav died of the same infection as he was recovering from COVID-19. He developed fibrosis in the lungs.

What we know about the treatment

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.

If you are showing any symptoms or if you have recently recovered from COVID-19 and have a compromised immunity, then it is advisable to consult your doctor and get checked once.